Provider Demographics
NPI:1821662701
Name:FLOURISHING LIFE HOLISTIC HEALTHCARE, LLC
Entity Type:Organization
Organization Name:FLOURISHING LIFE HOLISTIC HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC, PMHNP-BC
Authorized Official - Phone:931-624-6828
Mailing Address - Street 1:1104 STILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8653
Mailing Address - Country:US
Mailing Address - Phone:931-624-6828
Mailing Address - Fax:
Practice Address - Street 1:1820 MEMORIAL DR STE 101
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4693
Practice Address - Country:US
Practice Address - Phone:931-553-4161
Practice Address - Fax:931-553-4176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-16
Last Update Date:2021-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty