Sister's Place Group Home II

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

287-2006 Issued in VA

Legal business name

SISTER'S PLACE GROUP HOME II

Doing business as

Boundless Potential,LLC

Practice address

10204 Spinning Wheel Way
Richmond, VA 23233-2750

Phone

(804) 290-0216

Fax

(804) 290-0427

NPI assigned

Oct 9, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Deborah Malone Ralph, L.C.S.W.

Title

Ceo

Phone

(804) 290-0216

Specialties & licenses 1

Addresses

Other names 1

• Boundless Potential,LLC Doing business as

Tax ID family

Boundless Potential LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Boundless Potential, LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Richmond, VA
  • NPI 1679601280
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831286806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10204 SPINNING WHEEL WAY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232332750",
            "telephone_number": "804-290-0216",
            "fax_number": "804-290-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10204 SPINNING WHEEL WAY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232332750",
            "telephone_number": "804-290-0216",
            "fax_number": "804-290-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTER'S PLACE GROUP HOME II",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RALPH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "MALONE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-290-0216",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "VA",
            "license": "287-2006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boundless Potential,LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dimitrios N Sismanis, MD
• Alfredo S Sison Jr., M.D.
• Evan Mack Sisson, PHARM.D.
• Megan Sisson, LPTA
• Miles Sisson, M.ED., CCC-SLP
• Sakita Nicole Sistrun, MS, RD
• Taijanique Laasia Sistrunk
• Anne Marie Sitarz, PH.D.
• Jennifer Lee Sites, M.S. CCC-SLP
• Sitter-Barfoot Veterans Care Center (Sitter and Barfoot Veterans Care Center)

• Case Manager/Care Coordinator in Richmond, VA
• Providers in Richmond, VA by specialty
• Case Manager/Care Coordinator in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.