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General NPI Number Information
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NPI Number | 1780852897
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Entity Type | Organization
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Legal Business Name | PROSPERITY IN HEALTH
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 4903 RIDGE HARBOR DR
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City | HOUSTON
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State | TX
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Zip | 77053-5319
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Country | US
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Telephone | 832-880-3778
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Fax | 832-201-9750
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Provider Business Mailing Address
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Address Line | 3139 W HOLCOMBE BLVD 173
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City | HOUSTON
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State | TX
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Zip | 77025-1505
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Country | US
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Telephone | 832-880-3778
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Fax | 832-201-9750
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. URSULA BOYKINS
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Credential |
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Telephone | 832-880-3778
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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 | 36369
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License Number State | TX
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