Provider Demographics
NPI:1023606373
Name:THE CENTER OF PROSPER LLC
Entity type:Organization
Organization Name:THE CENTER OF PROSPER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUQAYYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-464-4325
Mailing Address - Street 1:3217 GLANZMAN RD UNIT 37
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3868
Mailing Address - Country:US
Mailing Address - Phone:419-464-4325
Mailing Address - Fax:
Practice Address - Street 1:1826 W BANCROFT ST STE 3
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-5002
Practice Address - Country:US
Practice Address - Phone:419-464-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health