Provider Demographics
NPI:1841028867
Name:PROSPERITY COMMUNITY
Entity type:Organization
Organization Name:PROSPERITY COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLLE
Authorized Official - Middle Name:CLARISSA
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-997-2243
Mailing Address - Street 1:5161 SAN FELIPE ST STE 320
Mailing Address - Street 2:#5019
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3640
Mailing Address - Country:US
Mailing Address - Phone:832-997-2243
Mailing Address - Fax:
Practice Address - Street 1:10754 S GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3509
Practice Address - Country:US
Practice Address - Phone:832-997-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care