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General NPI Number Information
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NPI Number | 1881216430
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Entity Type | Organization
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Legal Business Name | PROSPER HOME HEALTH AND TRANSPORTATION SERVICES
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Dates
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Enumeration Date | 05/16/2020
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 10025 COLFAX AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3133
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Country | US
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Telephone | 612-876-1187
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Fax |
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Provider Business Mailing Address
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Address Line | 10025 COLFAX AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3133
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Country | US
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Telephone | 612-876-1187
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Fax |
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Authorized Official
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Title or Position | RN AND ADMINISTRATOR
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Name | IFRAH D ALI
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Credential | RN AND ADMINISTRATOR
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Telephone | 858-877-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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