Optimal Health & Balance Llc - Medicare Mental Health Clinic in Bristol, WI

Optimal Health & Balance Llc is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Bristol, Wisconsin. The current practice location for Optimal Health & Balance Llc is 6925 184th Ave, Bristol, Wisconsin. For appointments, you can reach them via phone at (262) 358-2954. The mailing address for Optimal Health & Balance Llc is 6925 184th Avenue, Bristol, Wisconsin and phone number is (262) 358-2954.

Optimal Health & Balance Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1255072708. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (262) 358-2954.

Contact Information

Optimal Health & Balance Llc
6925 184th Ave
Bristol
WI 53104-9747
(262) 358-2954
Not Available

Mental Health Clinic Profile

Full NameOptimal Health & Balance Llc
SpecialityClinic/Center
Location6925 184th Ave, Bristol, Wisconsin
Authorized Official Name and PositionImelda N Forsberg (FAMILY NURSE PRACTITIONER)
Authorized Official Contact2623582954
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Optimal Health & Balance Llc
6925 184th Avenue
Bristol
WI 53104-9747

Ph: (262) 358-2954
Optimal Health & Balance Llc
6925 184th Ave
Bristol
WI 53104-9747

Ph: (262) 358-2954

NPI Details:

NPI Number1255072708
Provider Enumeration Date04/06/2022
Last Update Date04/06/2022
Certification Date04/06/2022

Medicare PECOS Information:

Medicare PECOS PAC ID6507232212
Medicare Enrollment IDO20221021000114

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Medical Identifiers

Medical identifiers for Optimal Health & Balance Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255072708NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Optimal Health & Balance Llc acts as a billing entity for following providers:
Provider NameImelda N Forsberg
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306027891
PECOS PAC ID: 8426132994
Enrollment ID: I20120809000834

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Clinic/Center in Bristol, WI

Heal From Within
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 6401 205th Ave, Bristol, WI 53104
Phone: 847-774-2264    

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