Healthcare Provider Details

I. General information

NPI: 1538083449
Provider Name (Legal Business Name): BOING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 CRESCENT RIDGE RD
BISMARCK ND
58503-6819
US

IV. Provider business mailing address

4251 CRESCENT RIDGE RD
BISMARCK ND
58503-6819
US

V. Phone/Fax

Practice location:
  • Phone: 844-264-6420
  • Fax:
Mailing address:
  • Phone: 844-264-6420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DUSTIN ADAM EDDY
Title or Position: MANAGING MEMBER
Credential: CPSS II
Phone: 844-264-6420