Provider Demographics
NPI:1821709403
Name:ENDEAVOR BALANCE, LLC
Entity Type:Organization
Organization Name:ENDEAVOR BALANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-497-5207
Mailing Address - Street 1:51 E JEFFERSON ST # 1326
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1832
Mailing Address - Country:US
Mailing Address - Phone:407-497-5207
Mailing Address - Fax:
Practice Address - Street 1:2650 DADE AVE APT 1404
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4657
Practice Address - Country:US
Practice Address - Phone:407-497-5207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty