Provider Demographics
NPI:1952164675
Name:BALANCE FOUNDATION INC
Entity type:Organization
Organization Name:BALANCE FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TITUS
Authorized Official - Middle Name:KIMANI
Authorized Official - Last Name:MWANGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-386-6705
Mailing Address - Street 1:5625 W EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-5247
Mailing Address - Country:US
Mailing Address - Phone:858-386-6705
Mailing Address - Fax:
Practice Address - Street 1:3209 S SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-5641
Practice Address - Country:US
Practice Address - Phone:858-386-6705
Practice Address - Fax:605-307-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder