OrganizationFlourishing Mind Body Wellness Center, A Collaborative Acupuncture PcAcupuncturistOther Service ProvidersPractice Address1554 S Sepulveda Blvd Ste 209, Los Angeles, CA 90025-3359(310) 401-4065PECOS EnrollmentBased on the most recent information from CMS, provider Flourishing Mind Body Wellness Center, A Collaborative Acupuncture Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1063870822Provider TypeOrganizationFull NameFlourishing Mind Body Wellness Center, A Collaborative Acupuncture PcSubpartNoEnumeration Date2/8/2016Last Updated2/26/2019Contact InformationPractice LocationPractice Address1554 S Sepulveda Blvd Ste 209, Los Angeles, CA 90025-3359Phone(310) 401-4065FaxUnlisted FaxMailing LocationMailing Address1112 Montana Ave Ste 528, Santa Monica, CA 90403-7326Phone(310) 401-4065FaxUnlisted FaxAuthorized OfficialNameUejo Marchand, Keri (Ceo/President)Phone(310) 401-4065Provider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicense16926California