Provider Demographics
NPI:1386332542
Name:BALANCED MENTAL WELLNESS LLC
Entity type:Organization
Organization Name:BALANCED MENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATYLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:HYMAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:775-293-2606
Mailing Address - Street 1:954 BLUEJAY DR
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-7253
Mailing Address - Country:US
Mailing Address - Phone:775-293-2606
Mailing Address - Fax:
Practice Address - Street 1:401 RAILROAD ST STE 206
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-3760
Practice Address - Country:US
Practice Address - Phone:775-293-2606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty