Provider Demographics
NPI:1821809351
Name:BALANCED MIND AND WELLNESS
Entity type:Organization
Organization Name:BALANCED MIND AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-881-9773
Mailing Address - Street 1:481 HACKENSACK AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6330
Mailing Address - Country:US
Mailing Address - Phone:201-881-9773
Mailing Address - Fax:
Practice Address - Street 1:481 HACKENSACK AVE FL 2
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6330
Practice Address - Country:US
Practice Address - Phone:201-881-9773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty