1740509876 NPI number — BALANCED HOME HEALTHCARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740509876 NPI number — BALANCED HOME HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BALANCED HOME HEALTHCARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740509876
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1645 PALM BEACH LAKES BLVD.
Provider Second Line Business Mailing Address:
SUITE 1100
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33401-2218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-697-3606
Provider Business Mailing Address Fax Number:
561-697-3614

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4042 PARK OAKS BLVD STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33610-9543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-963-1200
Provider Business Practice Location Address Fax Number:
813-863-0404
Provider Enumeration Date:
05/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HYNES
Authorized Official First Name:
JAMIE
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-697-3606

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  299993782 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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