Healthcare Provider Details

I. General information

NPI: 1154298032
Provider Name (Legal Business Name): 1 PROSPERITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 1ST PL SW
VERO BEACH FL
32962-3415
US

IV. Provider business mailing address

1975 1ST PL SW
VERO BEACH FL
32962-3415
US

V. Phone/Fax

Practice location:
  • Phone: 772-205-2497
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: OBED BAZILE
Title or Position: CEO
Credential:
Phone: 772-205-2497