Provider Demographics
NPI:1568231637
Name:PROSPERING CARE LLC
Entity Type:Organization
Organization Name:PROSPERING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JADA
Authorized Official - Middle Name:MAYOWA
Authorized Official - Last Name:VAUGHN OLAJIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-620-5643
Mailing Address - Street 1:2930 PLUM CREEK LN APT 1103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-2376
Mailing Address - Country:US
Mailing Address - Phone:281-620-5643
Mailing Address - Fax:
Practice Address - Street 1:2930 PLUM CREEK LN APT 1103
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-2376
Practice Address - Country:US
Practice Address - Phone:281-620-5643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health