Provider Demographics
NPI:1285013102
Name:PROSPERITY SOCIAL & COMMUNITY DEVELOPMENT GROUP, INC.
Entity Type:Organization
Organization Name:PROSPERITY SOCIAL & COMMUNITY DEVELOPMENT GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NADEGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:305-308-5899
Mailing Address - Street 1:1125 NE 125TH ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5034
Mailing Address - Country:US
Mailing Address - Phone:786-235-9597
Mailing Address - Fax:305-397-0935
Practice Address - Street 1:1125 NE 125TH ST
Practice Address - Street 2:SUITE 225
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5034
Practice Address - Country:US
Practice Address - Phone:786-235-9597
Practice Address - Fax:305-397-0935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management