Provider Demographics
NPI:1124980206
Name:VIDA IN BALANCE, LLC
Entity type:Organization
Organization Name:VIDA IN BALANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:ARMIJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-717-5767
Mailing Address - Street 1:412 DEVONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNG AMERICA
Mailing Address - State:MN
Mailing Address - Zip Code:55397-9621
Mailing Address - Country:US
Mailing Address - Phone:303-717-5767
Mailing Address - Fax:303-717-5767
Practice Address - Street 1:3317 S HIGLEY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-5436
Practice Address - Country:US
Practice Address - Phone:303-717-5767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-26
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center