Provider Demographics
NPI:1104198068
Name:BOUNDLESS HOME CARE
Entity Type:Organization
Organization Name:BOUNDLESS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:704-406-9206
Mailing Address - Street 1:820 S POST RD STE B
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6931
Mailing Address - Country:US
Mailing Address - Phone:704-406-9206
Mailing Address - Fax:704-406-9857
Practice Address - Street 1:820 S POST RD STE B
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6931
Practice Address - Country:US
Practice Address - Phone:704-406-9206
Practice Address - Fax:704-406-9857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4499253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care