Healthcare Provider Details
I. General information
NPI: 1265130801
Provider Name (Legal Business Name): FLOURISHING ACHIEVEMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2023
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
302 STONECHASE DR
ENTERPRISE AL
36330-2717
US
IV. Provider business mailing address
302 STONECHASE DR
ENTERPRISE AL
36330-2717
US
V. Phone/Fax
- Phone: 334-203-4335
- Fax: 205-255-5300
- Phone: 334-203-4335
- Fax: 205-255-5300
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMINA
WESTMORELAND
Title or Position: OWNER
Credential: BCBA, LBA
Phone: 334-203-4335