Provider Demographics
NPI:1831665025
Name:BALANCE THERAPEUTICS
Entity Type:Organization
Organization Name:BALANCE THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-587-1768
Mailing Address - Street 1:114 POINTE SOUTH DR STE B
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-9520
Mailing Address - Country:US
Mailing Address - Phone:336-587-1768
Mailing Address - Fax:
Practice Address - Street 1:114 POINTE SOUTH DR STE B
Practice Address - Street 2:
Practice Address - City:RANDLEMAN
Practice Address - State:NC
Practice Address - Zip Code:27317-9520
Practice Address - Country:US
Practice Address - Phone:336-587-1768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health