Organization · NPI-2

Flourishing Lives INC

Occupational Therapist · Saint Clair Shores, MI

NPI number1699377960
StatusActive
Last updated in NPPESJul 28, 2024

Details

NPI
1699377960
Entity type
Organization (NPI-2)
Legal business name
Flourishing Lives INC
Organization subpart
No
Enumeration date
Nov 12, 2020
Certification date
Jul 28, 2024
Last updated
Jul 28, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist––Yes
235Z00000X Speech-Language Pathologist,––

Practice location

30801 Jefferson Ave
Saint Clair Shores, MI 48082-1732

Phone 586-293-1234

Mailing address

128 Brooklet Cir
Saint Marys, GA 31558-9057

Phone 219-427-7839

Authorized official

Gwen Claussen
Ceo
2194277839

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