Organization
I AM BOUNDLESS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE B HICKMAN (CONTRACTING & CREDENTIALING MANAGER)
(614) 844-3800
Entity
Organization
Contact information
Practice address
1125 GREEN TREE DR, DAYTON, OH 45429-6104
(614) 844-3800
(614) 515-5779
Mailing address
445 E DUBLIN GRANVILLE RD STE H, WORTHINGTON, OH 43085-3192
(614) 844-3800
(614) 844-3800
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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