Provider Demographics
NPI:1316304595
Name:BALANCE & HEARING RESOURCE CENTERS
Entity type:Organization
Organization Name:BALANCE & HEARING RESOURCE CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FRINTNER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:818-859-7730
Mailing Address - Street 1:2211 W MAGNOLIA BLVD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1753
Mailing Address - Country:US
Mailing Address - Phone:818-859-7730
Mailing Address - Fax:818-859-7732
Practice Address - Street 1:2211 W MAGNOLIA BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1753
Practice Address - Country:US
Practice Address - Phone:818-859-7730
Practice Address - Fax:818-859-7732
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BALANCE & HEARING RESOURCE CENTERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1440231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAU0014440Medicaid
AZAU0014440Medicaid