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General NPI Number Information
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NPI Number | 1033935598
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Entity Type | Organization
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Legal Business Name | FLOURISHING R US ENTERPRISE LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1233 TIANA ST
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City | ANNA
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State | TX
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Zip | 75409-1248
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Country | US
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Telephone | 401-359-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 1233 TIANA ST
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City | ANNA
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State | TX
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Zip | 75409-1248
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Country | US
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Telephone | 401-359-0701
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FOLASHADE MARGRET ADEYEMI
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Credential |
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Telephone | 401-359-0701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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