I Am Boundless, INC
Intermediate Care Facility, Intellectual Disabilities in Fairborn, OH. Organization (NPI-2).
NPI number1104700822
StatusActive
Last updated in NPPESAug 5, 2025
Details
- NPI
- 1104700822
- Entity type
- Organization (NPI-2)
- Legal business name
- I Am Boundless, INC
- Organization subpart
- No
- Enumeration date
- Aug 5, 2025
- Certification date
- Aug 5, 2025
- Last updated
- Aug 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | – | – | Yes |
Practice location
1460 Graceland DrFairborn, OH 45324-4374
Phone 614-844-3800 · Fax 614-515-5779
Mailing address
445 E Dublin Granville Rd Ste HWorthington, OH 43085-3192
Phone 614-844-3800 · Fax 614-844-3800
Authorized official
Laurie B Hickman
Contracting & Credentialing Manager
6148443800
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