Provider Demographics
NPI:1205112042
Name:AWAKENING BALANCE LLC
Entity type:Organization
Organization Name:AWAKENING BALANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:P
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-328-8878
Mailing Address - Street 1:8795 RALSTON RD
Mailing Address - Street 2:SUITE #127
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2364
Mailing Address - Country:US
Mailing Address - Phone:720-328-8878
Mailing Address - Fax:720-328-8878
Practice Address - Street 1:8795 RALSTON RD
Practice Address - Street 2:SUITE #127
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2364
Practice Address - Country:US
Practice Address - Phone:720-328-8878
Practice Address - Fax:720-328-8878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1701171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty