Healthcare Provider Details
I. General information
NPI: 1467598268
Provider Name (Legal Business Name): PROSPERITY HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11628 S CHOCTAW DR SUITE 227
BATON ROUGE LA
70815-2107
US
IV. Provider business mailing address
11628 S CHOCTAW DR SUITE 227
BATON ROUGE LA
70815-2107
US
V. Phone/Fax
- Phone: 227-275-5999
- Fax: 225-275-6611
- Phone: 227-275-5999
- Fax: 225-275-6611
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | PCA6968 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | SIL7099 |
| License Number State | LA |
VIII. Authorized Official
Name: MISS
ERICA
L
WILLIAMS
Title or Position: MANAGER
Credential:
Phone: 225-275-5999