| Balanzen Mental Health Corp. | |
|
7630 145th St W Ste 201 Apple Valley MN 55124-7553 | |
| (612) 298-5176 | |
| Not Available |
| Full Name | Balanzen Mental Health Corp. |
|---|---|
| Speciality | Clinic/Center |
| Location | 7630 145th St W Ste 201, Apple Valley, Minnesota |
| Authorized Official Name and Position | Princess Gehyigon-wallace (OWNER) |
| Authorized Official Contact | 6122985176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balanzen Mental Health Corp. 7630 145th St W Ste 201 Apple Valley MN 55124-7553 Ph: (612) 298-5176 | Balanzen Mental Health Corp. 7630 145th St W Ste 201 Apple Valley MN 55124-7553 Ph: (612) 298-5176 |
| NPI Number | 1437923117 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 08/20/2024 |
| Medicare PECOS PAC ID | 6103267166 |
|---|---|
| Medicare Enrollment ID | O20240508003902 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437923117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Princess K Gehyigon-wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275190027 PECOS PAC ID: 4284968991 Enrollment ID: I20190701001256 |
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