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Contact Information

LIFE BALANCE CLINIC LLC
1107 OPENWOOD ST
VICKSBURG, MS39183
 Phone: 601-831-4402
 Fax: 601-206-0672
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for LIFE BALANCE CLINIC LLC

NPI Number 1811244858
LBN Legal business name LIFE BALANCE CLINIC LLC
Authorized official ANNETTE BRYANT - (OWNER/PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/09/2012
Last updated 08/07/2018 - About 8 years ago
Identifiers
MS License # C6582
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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