Boundless Miracles, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BOUNDLESS MIRACLES, LLC

Practice address

820 S Post Rd
Shelby, NC 28152-6931

Phone

(704) 406-9813

Fax

(704) 406-9857

NPI assigned

Apr 9, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Ronald Keith Church

Title

Owner / Ceo

Phone

(704) 692-4700

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1831332691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S POST RD STE A",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526931",
            "telephone_number": "704-406-9813",
            "fax_number": "704-406-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S POST RD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526931",
            "telephone_number": "704-406-9813",
            "fax_number": "704-406-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNDLESS MIRACLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER / CEO",
        "authorized_official_telephone_number": "704-692-4700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Mizok Bostian, PA-S
• Richard Botelho, MD
• Yves Boudreau, MD
• Daniqua Tishawn Boulware, LCSW
• Boundless Home Care
• Tanzza Marie Bowman, FNP-BC
• Julia Q Brackett
• George Lee Bradley, DO
• Roslyn Vinson Braggs, PMHNP
• Michael Brame, M.D.

• Community/Behavioral Health Agency in Shelby, NC
• Providers in Shelby, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.