BOUNDLESS POTENTIAL LLC NPI 1679601280

NPI Information

NPI: 1679601280
Provider Name: BOUNDLESS POTENTIAL, LLC

Other Name: SISTER'S PLACE GROUP HOME II

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
10204 SPINNING WHEEL WAY
RICHMOND, VA
ZIP 23233
Phone: (804) 864-9001
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BOUNDLESS POTENTIAL, LLC is a residential treatment facility emotionally disturbed children in Richmond, VA. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. BOUNDLESS POTENTIAL, LLC NPI is 1679601280. The provider is registered as an organization entity type.
The provider Other Name Is Sister's Place Group Home Ii.

The provider's business location address is:

10204 SPINNING WHEEL WAY
RICHMOND, VA
ZIP 23233
Phone: (804) 864-9001
Fax: (804) 864-9002

The provider's authorized official is Deborah Malone Ralph .
The authorized official title is Director Of Clinical Services and has the following contact phone number (804) 901-3122.

The enumeration date for this NPI number is 3/2/2007 and was last updated on 8/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		287-2006	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	008907757	MEDICAID	VIRGINIA
2	008907759	MEDICAID	VIRGINIA
3	00010231159	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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