NPI 1598803124

Boundless Potential LLC

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Glen Allen, VA

Practice location

Address: 1005 Telegraph Station Ln, Glen Allen, VA 23060-4006
Phone: (804) 864-9001
Fax: (804) 864-9002
Mailing address: PO Box 15238, Richmond, VA 23227-0638

Authorised official

Name: Deborah Malone Ralph
Title: Director of Clinical Services
Phone: (804) 901-3122

Registered specialties (2)

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence SS-04-09 (VA)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Virginia →

Emotionally Disturbed Childrens' Residential Treatment Facility

Residential Treatment Facilities Taxonomy 322D00000X Licence SS-212-07 (VA)

Registry record

NPI: 1598803124
Entity type: Organization
NPI issued: 4 Feb 2007
Record last updated: 4 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.