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General NPI Number Information
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NPI Number | 1700689197
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Entity Type | Organization
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Legal Business Name | PROSPER COMMUNITY CARE SERVICES
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 2121 W 16TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72202
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Country | US
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Telephone | 501-918-0138
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Fax | 501-476-0351
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Provider Business Mailing Address
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Address Line | 1711 S SUMMIT ST
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City | LITTLE ROCK
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State | AR
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Zip | 72202-5917
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Country | US
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Telephone | 501-918-0138
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LYDIA PAGE
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Credential |
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Telephone | 501-918-0138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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