Organization
OPTIMUM BALANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL STANLEY GILL (OWNER)
(810) 771-8969
Entity
Organization
Contact information
Practice address
1537 N. LEROY STREET, SUITE D, FENTON, MI 48430
(810) 771-8969
Mailing address
1537 N LEROY ST STE D, FENTON, MI 48430-2795
(810) 771-8969
(844) 558-9767
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6401013238
MI
Other
Enumeration date
05/14/2017
Last updated
09/17/2020
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