Flourish Foundation

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

FLOURISH FOUNDATION

Doing business as

Flourish
The Flourish Foundation

Practice address

172 Water Oak Way
Dallas, GA 30157-8562

Phone

(480) 286-8603

NPI assigned

Jan 26, 2024

Last updated

Jan 26, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jonta Delisa TidwellNPI 1912524273

Title

Founder

Phone

(480) 286-8603

Specialties & licenses 2

Addresses

Other names 2

• Flourish Doing business as
• The Flourish Foundation Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonta Delisa Tidwell

  • Home Health Agency
  • Fargo, ND
  • NPI 1912524273
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1740042605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 WATER OAK WAY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301578562",
            "telephone_number": "480-286-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 WATER OAK WAY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301578562",
            "telephone_number": "480-286-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOURISH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "JONTA",
        "authorized_official_middle_name": "DELISA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "480-286-8603"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flourish",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Flourish Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenna Fisher, RD, LD
• Maricela Fisher, BCBA
• Talja Sharra Fletcher, NP
• Sohna Florence
• Florida Autism Center (Fusion Autism Center)
• Kathryn Flowers
• Savanna Jean Floyd, DOULA, CBE
• Foothills Counseling Associates Inc.
• Cynthia Ling Foster
• Kara Lynn Foster, MS, OTR/L

• Case Management Agency in Dallas, GA
• Providers in Dallas, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.