Provider Demographics
NPI:1972938975
Name:BALANCE HEALTH SYSTEMS
Entity Type:Organization
Organization Name:BALANCE HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:TILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:435-574-9777
Mailing Address - Street 1:120 W 1470 S STE C
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-6798
Mailing Address - Country:US
Mailing Address - Phone:877-454-3055
Mailing Address - Fax:
Practice Address - Street 1:120 W 1470 S STE C
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-6798
Practice Address - Country:US
Practice Address - Phone:877-454-3055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7300098-1205281P00000X, 282N00000X, 283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No281P00000XHospitalsChronic Disease Hospital
No283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
1801235502OtherLLHC NPI
UT7865804-1206OtherRD TILLER LICENSE
1497716344OtherNPI
1881630572OtherNPI
UT7300098-1205OtherA MARTINEZ LICENSE