Healthcare Provider Details

I. General information

NPI: 1609790872
Provider Name (Legal Business Name): FLOURISH COMMUNITY LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3403 PRETTY BAYOU CT
PANAMA CITY FL
32405-1750
US

IV. Provider business mailing address

3403 PRETTY BAYOU CT
PANAMA CITY FL
32405-1750
US

V. Phone/Fax

Practice location:
  • Phone: 336-898-3451
  • Fax:
Mailing address:
  • Phone: 336-898-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LATONYA NICOLE SWIFT
Title or Position: OWNER
Credential:
Phone: 336-898-3451