Provider Demographics
NPI:1134717507
Name:FLOURISH WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:FLOURISH WELLNESS CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:205-983-4450
Mailing Address - Street 1:3100 LORNA RD STE 211
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5451
Mailing Address - Country:US
Mailing Address - Phone:205-983-4450
Mailing Address - Fax:205-449-7782
Practice Address - Street 1:3100 LORNA RD STE 211
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-5451
Practice Address - Country:US
Practice Address - Phone:205-983-4450
Practice Address - Fax:205-449-7782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-01
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse PediatricsGroup - Multi-Specialty