Provider Demographics
NPI:1689469306
Name:FLOURISHING CARE HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FLOURISHING CARE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/CNA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:B
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:352-219-2619
Mailing Address - Street 1:22118 SE 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:FL
Mailing Address - Zip Code:32640-3967
Mailing Address - Country:US
Mailing Address - Phone:352-219-2619
Mailing Address - Fax:
Practice Address - Street 1:22118 SE 71ST AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:FL
Practice Address - Zip Code:32640-3967
Practice Address - Country:US
Practice Address - Phone:352-219-2619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL147001OtherDEPARTMENT OF HEALTH (MEDICAL QUALITY ASSURANCE DIVISION)