Organization
BOUNDLESS MIRACLES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD KEITH CHURCH (OWNER / CEO)
(704) 692-4700
Entity
Organization
Contact information
Practice address
820 S POST RD, SHELBY, NC 28152-6931
(704) 406-9813
(704) 406-9857
Mailing address
820 S POST RD STE A, SHELBY, NC 28152-6931
(704) 406-9813
(704) 406-9857
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
04/09/2009
Last updated
04/23/2018
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