Provider Demographics
NPI:1548812225
Name:FLINT HEALTHCARE LLC
Entity type:Organization
Organization Name:FLINT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-232-2436
Mailing Address - Street 1:7732 HOLLY BERRY TER
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-3416
Mailing Address - Country:US
Mailing Address - Phone:678-232-2436
Mailing Address - Fax:
Practice Address - Street 1:1400 E SHOTWELL ST STE 125
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4277
Practice Address - Country:US
Practice Address - Phone:678-232-2436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health