Provider Demographics
NPI:1699168880
Name:BALANCE HEALTH WELLNESS MHHA
Entity type:Organization
Organization Name:BALANCE HEALTH WELLNESS MHHA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:GEHRI
Authorized Official - Suffix:
Authorized Official - Credentials:LVN, BS
Authorized Official - Phone:805-651-0975
Mailing Address - Street 1:6645 THILLE ST
Mailing Address - Street 2:#195
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7501
Mailing Address - Country:US
Mailing Address - Phone:805-651-0975
Mailing Address - Fax:805-364-5944
Practice Address - Street 1:6645 THILLE ST
Practice Address - Street 2:#195
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7501
Practice Address - Country:US
Practice Address - Phone:805-651-0975
Practice Address - Fax:805-364-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN235627251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health