Provider Demographics
NPI:1801517545
Name:BALANCED MIND BEHAVIORAL HEALTHCARE INC
Entity type:Organization
Organization Name:BALANCED MIND BEHAVIORAL HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPUNKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-677-0750
Mailing Address - Street 1:PO BOX 382896
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75138-2896
Mailing Address - Country:US
Mailing Address - Phone:817-677-0750
Mailing Address - Fax:
Practice Address - Street 1:5050 QUORUM DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7564
Practice Address - Country:US
Practice Address - Phone:817-677-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty