Provider Demographics
NPI:1447879465
Name:FAMILY BALANCE THERAPY, LLC
Entity type:Organization
Organization Name:FAMILY BALANCE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLOR DE LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-263-3965
Mailing Address - Street 1:8600 SW 212TH ST APT 210
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3812
Mailing Address - Country:US
Mailing Address - Phone:786-771-3370
Mailing Address - Fax:
Practice Address - Street 1:8600 SW 212TH ST APT 210
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3812
Practice Address - Country:US
Practice Address - Phone:786-771-3370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty