| Balm Therapeutic Services, Llc | |
|
111 Church St. Suite 103 Ferguson MO 63135 | |
| (314) 292-9142 | |
| (314) 480-7059 |
| Full Name | Balm Therapeutic Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 111 Church St., Ferguson, Missouri |
| Authorized Official Name and Position | Erika Ware (OWNER) |
| Authorized Official Contact | 3142929142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Balm Therapeutic Services, Llc 3722 Candlewyck Club Dr Apt D Florissant MO 63034-2585 Ph: (314) 616-8919 | Balm Therapeutic Services, Llc 111 Church St. Suite 103 Ferguson MO 63135 Ph: (314) 292-9142 |
| NPI Number | 1720671514 |
|---|---|
| Provider Enumeration Date | 02/12/2021 |
| Last Update Date | 12/20/2021 |
| Certification Date | 12/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720671514 | NPI | - | NPPES |
| 490020305 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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