Provider Demographics
NPI:1215460043
Name:BALANCE IN LIFE COMMUNITY SERVICES
Entity type:Organization
Organization Name:BALANCE IN LIFE COMMUNITY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-671-3709
Mailing Address - Street 1:13500 SW 88TH ST STE 285B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1547
Mailing Address - Country:US
Mailing Address - Phone:305-671-3709
Mailing Address - Fax:
Practice Address - Street 1:13500 SW 88TH ST STE 285B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1547
Practice Address - Country:US
Practice Address - Phone:305-671-3709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-08
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management