Tidal Balanced Wellness Center
LBN: Tidal Balanced Wellness Center
Tidal Balanced Wellness Center is an health care organization with primary practice located at 325 Tacoma Ave S Ste 1 , Tacoma WA 98402-2550. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty.
Tidal Balanced Wellness Center can be contacted via phone (757) 921-7704, or through Crayton, Shannon Barello via phone (757) 921-7704.
Contact Information
Primary practice address
325 Tacoma Ave S Ste 1
Tacoma WA 98402-2550
Phone: (757) 921-7704
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X |
Profile Details
| NPI number | 1558958991 |
|---|---|
| LBN Legal business name | Tidal Balanced Wellness Center |
| DBA Doing business as | Tidal Balanced Wellness Center |
| Authorized official | Crayton, Shannon Barello LICSW |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 30th, 2020 |
| Last updated | Apr 10th, 2024 - about 8 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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