Provider Demographics
NPI:1801404272
Name:BALANCED RESTORATION SERVICES, LLC
Entity Type:Organization
Organization Name:BALANCED RESTORATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-239-0870
Mailing Address - Street 1:701 MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2645
Mailing Address - Country:US
Mailing Address - Phone:989-239-0870
Mailing Address - Fax:734-800-3183
Practice Address - Street 1:132 E GRAND RIVER AVE STE 205
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1510
Practice Address - Country:US
Practice Address - Phone:734-489-1182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)