Bal Professional Healthcare Services Inc

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

License

075-R-0832 Issued in GA

Legal business name

BAL PROFESSIONAL HEALTHCARE SERVICES INC

Doing business as

BAL COMPREHENSIVE OUTPATIENT REHABILITAITON FACILITY

Practice address

155 Westridge Pkwy
Suite 208
McDonough, GA 30253-3049

Phone

(678) 782-5400

Fax

(678) 782-3330

NPI assigned

Apr 4, 2016

Organization subpart

Yes

Parent organization

I-CARE PRIVATE HOME CARE SERVICES LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Brenda A Roberts

Title

Secretary

Phone

(678) 763-6722

Specialties & licenses 3

Addresses

Other names 1

• BAL COMPREHENSIVE OUTPATIENT REHABILITAITON FACILITY Doing business as

Part of

I-Care Private Home Care Services LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1598128779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WESTRIDGE PKWY",
            "address_2": "SUITE 208",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533049",
            "telephone_number": "678-782-5400",
            "fax_number": "678-782-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WESTRIDGE PKWY",
            "address_2": "SUITE 208",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533049",
            "telephone_number": "678-782-5400",
            "fax_number": "678-782-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAL PROFESSIONAL HEALTHCARE SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "I-CARE PRIVATE HOME CARE SERVICES LLC",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "678-763-6722",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "GA",
            "license": "075-R-0832",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "GA",
            "license": "075-R-0832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAL COMPREHENSIVE OUTPATIENT REHABILITAITON FACILITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Elizabeth Bailey, M.ED., CCC-SLP
• Susan Melinda Bailey, FNP-BC
• Tonya Bailey
• Angela Marie Baisden-Powell, FNP-C
• Rebecca Baker, FNP-C
• Heather Cowan Balsam, PHARMD
• Matthew Dong Hun Ban
• Demonica Banks
• Te'Lesha Baratta
• Phillip Barclay

• Comprehensive Outpatient Rehabilitation Facility (CORF) in McDonough, GA
• Providers in McDonough, GA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.