| Balance And Renewal Pllc | |
|
2705 E 17th St Ammon ID 83406-6669 | |
| (208) 534-6484 | |
| Not Available |
| Full Name | Balance And Renewal Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2705 E 17th St, Ammon, Idaho |
| Authorized Official Name and Position | Adam Nickell (OWNER/ PROVIDER) |
| Authorized Official Contact | 2085346484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Balance And Renewal Pllc 3270 E 17th St # 131 Ammon ID 83406-6758 Ph: (208) 534-6484 | Balance And Renewal Pllc 2705 E 17th St Ammon ID 83406-6669 Ph: (208) 534-6484 |
| NPI Number | 1790645638 |
|---|---|
| Provider Enumeration Date | 11/13/2025 |
| Last Update Date | 11/13/2025 |
| Certification Date | 11/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790645638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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