Healthcare Provider Details

I. General information

NPI: 1871237453
Provider Name (Legal Business Name): PROSPECTIVE HEALTHCARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6862 BUTLER AVE
LONG BEACH CA
90805-1341
US

IV. Provider business mailing address

6862 BUTLER AVE
LONG BEACH CA
90805-1341
US

V. Phone/Fax

Practice location:
  • Phone: 562-208-2354
  • Fax:
Mailing address:
  • Phone: 562-208-2354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: LETITIA WILLIAMS
Title or Position: CEO/OWNER
Credential:
Phone: 562-208-2354