Organization
FLOURISH FOUNDATION
Active
Other names
Flourish, The Flourish Foundation
Organization subpart
No
Provider details
NPI number
Authorized official
JONTA DELISA TIDWELL (FOUNDER)
(480) 286-8603
Entity
Organization
Contact information
Practice address
172 WATER OAK WAY, DALLAS, GA 30157-8562
(480) 286-8603
Mailing address
172 WATER OAK WAY, DALLAS, GA 30157-8562
(480) 286-8603
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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