Provider Demographics
NPI:1245940436
Name:NUBALANCE BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:NUBALANCE BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:AMICI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-603-3140
Mailing Address - Street 1:116 W KING ST FL 1
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2412
Mailing Address - Country:US
Mailing Address - Phone:610-466-5335
Mailing Address - Fax:610-465-9688
Practice Address - Street 1:116 W KING ST FL 1
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-2412
Practice Address - Country:US
Practice Address - Phone:610-466-5335
Practice Address - Fax:610-465-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty