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Organization
PROSPERITY HEALTH SERVICES, LLC
Active
Organization
PROSPERITY HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLEOTHA MONTGOMERY (OWNER)
(972) 296-1901
Entity
Organization
Contact information
Practice address
1615 N HAMPTON RD, SUITE 130, DESOTO, TX 75115-8303
(972) 296-1901
(972) 296-5590
Mailing address
1615 N HAMPTON RD, SUITE 130, DESOTO, TX 75115-8303
(972) 296-1901
(972) 296-5590
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
011923
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
453189
MEDICARE
TX
Enumeration date
12/03/2007
Last updated
01/13/2012
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