Sister'S Place Group Home I

LBN: Boundless Potential Llc
Sister'S Place Group Home I is an health care organization with primary practice located at 1005 Telegraph Station Ln , Glen Allen VA 23060-4006. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Boundless Potential Llc can be contacted via phone (804) 864-9001, or through Ralph, Deborah Malone via phone (804) 901-3122.

Contact Information

Primary practice address
1005 Telegraph Station Ln Glen Allen VA 23060-4006
Phone: (804) 864-9001
Fax: (804) 864-9002
Website:
Map and Directions
Authorized official contact:
Name: Ralph, Deborah Malone Licensed Clinical Social Worker (LCSW)
Phone: (804) 901-3122

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X SS-04-09 Virginia
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X SS-212-07 Virginia

Profile Details

NPI number 1598803124
LBN Legal business name Boundless Potential Llc
DBA Doing business as Sister'S Place Group Home I
Authorized official Ralph, Deborah Malone Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 4th, 2007
Last updated Aug 4th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598803124 NPPES
Virginia MEDICAID 00010231159
Virginia MEDICAID 008907757

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