| Boundless Behavioral Llc | |
|
3495 English Oaks Dr Nw Kennesaw GA 30144-5794 | |
| (470) 992-3607 | |
| (678) 401-8381 |
| Full Name | Boundless Behavioral Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3495 English Oaks Dr Nw, Kennesaw, Georgia |
| Authorized Official Name and Position | Eric Jermaine Rogers (OPERATIONS DIRECTOR) |
| Authorized Official Contact | 4709923607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boundless Behavioral Llc 3495 English Oaks Dr Nw Kennesaw GA 30144-5794 Ph: (470) 992-3607 | Boundless Behavioral Llc 3495 English Oaks Dr Nw Kennesaw GA 30144-5794 Ph: (470) 992-3607 |
| NPI Number | 1710671748 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710671748 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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