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General NPI Number Information
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NPI Number | 1952230963
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Entity Type | Organization
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Legal Business Name | CI PROSPERITY CARE SERVICES LLC
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 238 OLD BAY DR
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City | PATASKALA
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State | OH
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Zip | 43062-7899
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Country | US
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Telephone | 217-693-8722
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Fax | 999-999-9999
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Provider Business Mailing Address
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Address Line | 238 OLD BAY DR
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City | PATASKALA
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State | OH
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Zip | 43062-7899
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Country | US
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Telephone | 217-693-8722
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBERS
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Name | CHRISTOPHER INYINDJOLOHANGA
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Credential |
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Telephone | 217-693-8722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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