Provider Demographics
| NPI: | 1255415881 |
|---|---|
| Name: | BALANCE REHABILITATION AND HEALTH SCIENCE, LLC |
| Entity type: | Organization |
| Organization Name: | BALANCE REHABILITATION AND HEALTH SCIENCE, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRACTICE MANAGER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JASON |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MASSA |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 603-890-8844 |
| Mailing Address - Street 1: | 58 RANGE RD STE 16 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WINDHAM |
| Mailing Address - State: | NH |
| Mailing Address - Zip Code: | 03087-2026 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 603-890-8844 |
| Mailing Address - Fax: | 603-890-8845 |
| Practice Address - Street 1: | 58 RANGE RD STE 16 |
| Practice Address - Street 2: | |
| Practice Address - City: | WINDHAM |
| Practice Address - State: | NH |
| Practice Address - Zip Code: | 03087-2026 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 603-890-8844 |
| Practice Address - Fax: | 603-890-8845 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-10-24 |
| Last Update Date: | 2024-03-19 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | Group - Multi-Specialty |
| No | 2251H1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Human Factors | Group - Multi-Specialty |
| No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics | Group - Multi-Specialty |
| No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | Group - Multi-Specialty |
| No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Multi-Specialty |
| No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NH | 3081238 | Medicaid |
