Provider Demographics
NPI:1215698386
Name:FLOURISH HEALTH, INC
Entity type:Organization
Organization Name:FLOURISH HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASKELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-863-4774
Mailing Address - Street 1:2852 N HAMLIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7202
Mailing Address - Country:US
Mailing Address - Phone:650-863-4774
Mailing Address - Fax:
Practice Address - Street 1:2852 N HAMLIN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7202
Practice Address - Country:US
Practice Address - Phone:650-863-4774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health