Organization
I AM BOUNDLESS, INC
Active
Parent organization
I AM BOUNDLESS, INC.
Other names
Evelyn Avenue Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
I AM BOUNDLESS, INC.
Authorized official
MICHELLE BARNER (REIMBURSEMENT MANAGER)
(614) 844-3800
Entity
Organization
Contact information
Practice address
592 EVELYN AVE, MANSFIELD, OH 44907-1787
(614) 844-3800
Mailing address
445 E DUBLIN GRANVILLE RD, WORTHINGTON, OH 43085-3192
(614) 844-3800
(614) 515-5779
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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