Provider Demographics
NPI:1427713544
Name:BALANCED MINDS BOSTON LLC
Entity type:Organization
Organization Name:BALANCED MINDS BOSTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLASH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-NP
Authorized Official - Phone:617-913-0928
Mailing Address - Street 1:350 HARRISON AVE UNIT 508
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3865
Mailing Address - Country:US
Mailing Address - Phone:617-913-0928
Mailing Address - Fax:
Practice Address - Street 1:350 HARRISON AVE UNIT 508
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-3865
Practice Address - Country:US
Practice Address - Phone:617-913-0928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty