Healthcare Provider Details

I. General information

NPI: 1629559349
Provider Name (Legal Business Name): UNLIMITED BOUNDS HUMAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 PENNINGTON AVE
BALTIMORE MD
21226-1324
US

IV. Provider business mailing address

1109 DULANEY GATE CIR
COCKEYSVILLE MD
21030-3012
US

V. Phone/Fax

Practice location:
  • Phone: 443-449-5135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name: MARKIS JOHNSON
Title or Position: CEO
Credential:
Phone: 443-449-5135