Provider Demographics
NPI:1164577656
Name:NO BOUNDARIES INTERGRATED SERVICES FOR INDEPENDENT LIVING
Entity Type:Organization
Organization Name:NO BOUNDARIES INTERGRATED SERVICES FOR INDEPENDENT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AIDE SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARIS
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:PLEMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:828-456-7930
Mailing Address - Street 1:6 ELYSINIA AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-2000
Mailing Address - Country:US
Mailing Address - Phone:828-456-7930
Mailing Address - Fax:828-456-7907
Practice Address - Street 1:6 ELYSINIA AVE
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-2000
Practice Address - Country:US
Practice Address - Phone:828-456-7930
Practice Address - Fax:828-456-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2549251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601091Medicaid