Provider Demographics
NPI:1982226809
Name:PROSPER HEALTH CARE LLC
Entity Type:Organization
Organization Name:PROSPER HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-421-6523
Mailing Address - Street 1:1370 PIKE LAKE CT
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6412
Mailing Address - Country:US
Mailing Address - Phone:614-623-8646
Mailing Address - Fax:
Practice Address - Street 1:1370 PIKE LAKE CT
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6412
Practice Address - Country:US
Practice Address - Phone:614-623-8646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health