Provider Demographics
NPI:1952921579
Name:PROSPERITY HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:PROSPERITY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHNY
Authorized Official - Middle Name:
Authorized Official - Last Name:EUGENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FNLP, CEO
Authorized Official - Phone:845-281-9722
Mailing Address - Street 1:419 NORTHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3091
Mailing Address - Country:US
Mailing Address - Phone:201-762-5090
Mailing Address - Fax:551-210-1912
Practice Address - Street 1:10000 LINCOLN DR E STE 201
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3105
Practice Address - Country:US
Practice Address - Phone:201-762-5090
Practice Address - Fax:551-210-1912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care