Healthcare Provider Details

I. General information

NPI: 1326721838
Provider Name (Legal Business Name): UNLIMITED BOUNDS HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 08/10/2023
Certification Date: 08/09/2023
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: 443-764-9551
  • Fax:
Mailing address:
  • Phone: 443-449-5135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

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