Provider Demographics
NPI:1881850923
Name:PROSPERITY IN HEALTH
Entity Type:Organization
Organization Name:PROSPERITY IN HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BOYKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:832-343-5931
Mailing Address - Street 1:3139 W HOLCOMBE BLVD
Mailing Address - Street 2:#173
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1505
Mailing Address - Country:US
Mailing Address - Phone:832-343-5931
Mailing Address - Fax:
Practice Address - Street 1:4903 RIDGE HARBOR DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77053-5319
Practice Address - Country:US
Practice Address - Phone:832-343-5931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163938701Medicaid
TX164134201Medicaid
TX159235402Medicaid
TX178043701Medicaid