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Organization
PROSPER ADOLESCENT CARE LLC
Active
Organization
PROSPER ADOLESCENT CARE LLC
Active
Other names
Prosper Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAM BAISDEN JR. (PARTNER)
(406) 890-5885
Entity
Organization
Contact information
Practice address
31733 S FORK YAAK RD STE B, TROY, MT 59935-8681
(855) 383-2566
Mailing address
6885 BAUMAN ST, BONNERS FERRY, ID 83805-8723
(855) 383-2566
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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