Provider Demographics
NPI:1760767453
Name:LIFE BALANCING CENTER
Entity Type:Organization
Organization Name:LIFE BALANCING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:316-214-5247
Mailing Address - Street 1:2707 W DOUGLAS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-2606
Mailing Address - Country:US
Mailing Address - Phone:316-260-5732
Mailing Address - Fax:888-416-7189
Practice Address - Street 1:2707 W DOUGLAS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-2606
Practice Address - Country:US
Practice Address - Phone:316-260-5732
Practice Address - Fax:888-416-7189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty