| Life Well Balanced Llc | |
|
103 Lincoln St O Fallon MO 63366-1603 | |
| (636) 443-3704 | |
| (636) 294-0530 |
| Full Name | Life Well Balanced Llc |
|---|---|
| Speciality | Social Worker |
| Location | 103 Lincoln St, O Fallon, Missouri |
| Authorized Official Name and Position | Sara Ann Carter (OWNER) |
| Authorized Official Contact | 6364433704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Well Balanced Llc 30 Oak Valley Dr Saint Peters MO 63376-3721 Ph: (636) 443-3704 | Life Well Balanced Llc 103 Lincoln St O Fallon MO 63366-1603 Ph: (636) 443-3704 |
| NPI Number | 1265939672 |
|---|---|
| Provider Enumeration Date | 04/11/2018 |
| Last Update Date | 04/11/2018 |
| Medicare PECOS PAC ID | 9931462686 |
|---|---|
| Medicare Enrollment ID | O20180411002675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265939672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2013045632 (Missouri) | Primary |
| Provider Name | Sara A Carter-jameson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073063343 PECOS PAC ID: 0345520326 Enrollment ID: I20161208001661 |
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