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General NPI Number Information
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NPI Number | 1346552809
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Entity Type | Organization
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Legal Business Name | PROSPERITY IN-HOME HEALTH CARE
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 2152 JEFFERSON DAVIS HWY C
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City | STAFFORD
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State | VA
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Zip | 22554-7281
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Country | US
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Telephone | 540-318-6416
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Fax | 540-318-6516
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Provider Business Mailing Address
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Address Line | PO BOX 2534
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City | STAFFORD
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State | VA
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Zip | 22555-2534
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Country | US
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Telephone | 540-318-6416
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CHASITY ELAINE ADAMS
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Credential |
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Telephone | 540-318-6416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | VA
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