| NPI | 1346838992 |
|---|---|
| Former Legal Business Name | BOUNDLESS BEHAVIORAL HEALTH, INC. |
| Entity Type | Organization |
| Authorized Contact | DERRICK YOUNG Contracting Credentialing Manager 614-844-2124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-10-20 |