MEDICARE: PROSPERITY HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	1020028	LA

General Provider Information

NPI Number	:	1447419148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROSPERITY HEALTH CARE

Provider Business Mailing Address
First Line	:	11628 S CHOCTAW DR STE 227
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-2107
Country	:	US
Telephone Number	:	225-275-5999
Fax Number	:	225-275-6611

Provider Business Practice Location Address
First Line	:	11628 S CHOCTAW DR STE 227
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-2107
Country	:	US
Telephone Number	:	225-275-5999
Fax Number	:	225-275-6611

Authorized Official
Title or Position	:	CO- OWNER
Name	:	ERICA RAYFORD
Credential	:
Telephone Number	:	225-275-5999

Provider Enumeration Date	:	06/06/2008
Last Update Date	:	06/06/2008

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Directions to “PROSPERITY HEALTH CARE ” Practice Location

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