Provider Demographics
NPI:1598572976
Name:ALEXIS FLOWERS LMSW, LLC
Entity type:Organization
Organization Name:ALEXIS FLOWERS LMSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER/LMSW
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:269-689-9104
Mailing Address - Street 1:126 EAST KILGORE ROAD
Mailing Address - Street 2:STE. 400 #444
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002
Mailing Address - Country:US
Mailing Address - Phone:269-689-0800
Mailing Address - Fax:
Practice Address - Street 1:726 N LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-1207
Practice Address - Country:US
Practice Address - Phone:269-689-9104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)