Provider Demographics
NPI:1124883533
Name:NURTURING BALANCE LLC.
Entity type:Organization
Organization Name:NURTURING BALANCE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-639-8488
Mailing Address - Street 1:4569 KUKUI ST APT 203
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1775
Mailing Address - Country:US
Mailing Address - Phone:808-664-6040
Mailing Address - Fax:
Practice Address - Street 1:4569 KUKUI ST APT 203
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1775
Practice Address - Country:US
Practice Address - Phone:808-664-6040
Practice Address - Fax:808-650-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty