Organization
BOUNDLESS INNOVATIONS FOR HOLISTC LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA J FOXWORTH (AUTHORIZED OFFICIAL)
(443) 562-0605
Entity
Organization
Contact information
Practice address
1500 UNION AVENUE, SUITE 117, BALTIMORE, MD 21211-1975
(410) 904-2412
(443) 817-0731
Mailing address
1313 1/2 KENT AVE, BALTIMORE, MD 21207-4829
(443) 904-2412
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH62
MD
Other
Enumeration date
04/15/2013
Last updated
06/19/2023
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