Healthcare Provider Details

I. General information

NPI: 1376149948
Provider Name (Legal Business Name): HEART OF UNLIMITED BOUNDARIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 REYNOLDS RD
WEST LIBERTY OH
43357-7505
US

IV. Provider business mailing address

3934 DARNELL RD
SPRINGFIELD OH
45504-4455
US

V. Phone/Fax

Practice location:
  • Phone: 614-800-3310
  • Fax:
Mailing address:
  • Phone: 937-408-9969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. PEARL CLINE
Title or Position: CEO
Credential:
Phone: 937-408-9969