PROSPER INTEGRATED HEALTH CARE NPI 1629659578

NPI Information

NPI: 1629659578
Provider Name: PROSPER INTEGRATED HEALTH CARE
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 03D2229068

Address:
10750 W MCDOWELL RD STE C305
AVONDALE, AZ
ZIP 85392
Phone: (623) 755-5679
Get Directions

PROSPER INTEGRATED HEALTH CARE is a health service clinic center in Avondale, AZ. PROSPER INTEGRATED HEALTH CARE NPI is 1629659578. The provider is registered as an organization entity type.

The provider's business location address is:

10750 W MCDOWELL RD STE C305
AVONDALE, AZ
ZIP 85392-964
Phone: (623) 755-5679

The provider's authorized official is Elonda Wilson .
The authorized official title is Coo and has the following contact phone number (860) 690-5309.

The CLIA number assigned to this NPI record is 03D2229068 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/20/2021 and was last updated on 11/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
2	261QH0100X	Clinic/Center	Health Service			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »