Organization · NPI-2

Advance Balance Alliance LLC

Counselor, Mental Health · Port St Lucie, FL

NPI number1851141022
StatusActive
Last updated in NPPESMar 22, 2024

Details

NPI
1851141022
Entity type
Organization (NPI-2)
Legal business name
Advance Balance Alliance LLC
Organization subpart
No
Enumeration date
Mar 22, 2024
Certification date
Mar 20, 2024
Last updated
Mar 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes
251S00000X Community/Behavioral Health––

Practice location

6044 Nw Wolverine Road
Port St Lucie, FL 34986

Phone 772-607-1008

Mailing address

1729 Nw Saint Lucie West Blvd # 1275
Port St Lucie, FL 34986-2501

Phone 772-607-1008

Authorized official

Yilian J Montes De Oca
Director
7726071008

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