Organization
BALANCE TREATMENT SLO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER CUSACK (CFO)
(323) 646-9271
Entity
Organization
Contact information
Practice address
1551 BISHOP ST, STE 130A, SAN LUIS OBISPO, CA 93401-4635
(805) 441-7566
Mailing address
4505 LAS VIRGENES RD, STE 201, CALABASAS, CA 91302-1956
(818) 880-0800
(818) 880-8910
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Enumeration date
07/27/2015
Last updated
06/15/2016
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