Provider Demographics
NPI:1063964906
Name:FLOURISH IN PLACE, LLC
Entity type:Organization
Organization Name:FLOURISH IN PLACE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KIMBARK
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-845-9797
Mailing Address - Street 1:1080 WOODCOCK RD STE 276
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3514
Mailing Address - Country:US
Mailing Address - Phone:407-845-9797
Mailing Address - Fax:321-400-1233
Practice Address - Street 1:1080 WOODCOCK RD STE 276
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3514
Practice Address - Country:US
Practice Address - Phone:407-845-9797
Practice Address - Fax:321-400-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234579253Z00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care