Provider Demographics
NPI:1881216430
Name:PROSPER HOME HEALTH AND TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:PROSPER HOME HEALTH AND TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN AND ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IFRAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:RN AND ADMINISTRATOR
Authorized Official - Phone:858-877-0066
Mailing Address - Street 1:10025 COLFAX AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3133
Mailing Address - Country:US
Mailing Address - Phone:612-876-1187
Mailing Address - Fax:
Practice Address - Street 1:10025 COLFAX AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-3133
Practice Address - Country:US
Practice Address - Phone:612-876-1187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-16
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness