Provider Demographics
NPI:1134099575
Name:BALANCED MAMA, LLC
Entity type:Organization
Organization Name:BALANCED MAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MMT, CD(DONA)
Authorized Official - Phone:501-680-6963
Mailing Address - Street 1:2601 KAVANAUGH BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3991
Mailing Address - Country:US
Mailing Address - Phone:501-680-6963
Mailing Address - Fax:
Practice Address - Street 1:2601 KAVANAUGH BLVD STE 7
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3991
Practice Address - Country:US
Practice Address - Phone:501-680-6963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty