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General NPI Number Information
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NPI Number | 1205779618
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Entity Type | Organization
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Legal Business Name | FLOURISH HEALTH MEDICAL PRACTICE, LTD.
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Dates
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Enumeration Date | 04/10/2026
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 204 8TH ST.
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City | MARLINTON
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State | WV
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Zip | 24954
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Country | US
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Telephone | 910-517-0097
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Fax |
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Provider Business Mailing Address
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Address Line | 169 MADISON AVE STE 80170
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN HASKELL
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Credential |
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Telephone | 910-447-6249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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