Provider Demographics
NPI:1548605330
Name:FLOWERS COMMUNITY LIVING, LLC
Entity Type:Organization
Organization Name:FLOWERS COMMUNITY LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-912-1055
Mailing Address - Street 1:8180 MCKENZIE PL
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-5898
Mailing Address - Country:US
Mailing Address - Phone:770-912-1055
Mailing Address - Fax:770-278-0284
Practice Address - Street 1:8180 MCKENZIE PL
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-5898
Practice Address - Country:US
Practice Address - Phone:770-912-1055
Practice Address - Fax:770-278-0284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACLA000868320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities