Provider Demographics
NPI:1043452345
Name:BALBOA COMMUNICATION CONSULTANTS, INC
Entity type:Organization
Organization Name:BALBOA COMMUNICATION CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIXIE
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:ST JOHN-EWERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-765-0422
Mailing Address - Street 1:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-0402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:307 BRIAR CLIFF ST SW
Practice Address - Street 2:
Practice Address - City:POPLAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:61065-8989
Practice Address - Country:US
Practice Address - Phone:815-765-0422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty