Provider Demographics
NPI:1720689888
Name:BALANCE TO HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:BALANCE TO HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUANDA
Authorized Official - Middle Name:LASHAWN
Authorized Official - Last Name:BANKS-MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:910-922-0441
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-1267
Mailing Address - Country:US
Mailing Address - Phone:910-922-0441
Mailing Address - Fax:
Practice Address - Street 1:5135 MORGANTON RD STE 201
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1525
Practice Address - Country:US
Practice Address - Phone:910-922-0441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty