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NPI Code Detail

MEDICARE: PROSPERLIFE HOME CARE LLC

MEDICARE: PROSPERLIFE HOME CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1447110986
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROSPERLIFE HOME CARE LLC
Provider Business Mailing Address
First Line : PO BOX 545
Second Line :
City : LA VILLA
State : TX
Zip : 78562-0545
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3679 MILE 14 1/2 N
Second Line :
City : MERCEDES
State : TX
Zip : 78570
Country : US
Telephone Number : 956-314-3663
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : JOHN MICHAEL GONZALEZ
Credential :
Telephone Number : 956-314-3663
Provider Enumeration Date : 11/17/2025
Last Update Date : 01/13/2026

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Directions to “PROSPERLIFE HOME CARE LLC ” Practice Location

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