Organization
A PROSPERING VISION HOLISTIC MEDICAL SERVICES, LLC
Active
Parent organization
A PROSPERING VISION, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
A PROSPERING VISION, LLC
Authorized official
MR. ELIJAH CALDWELL LCSW (EXECUTIVE DIRECTOR)
(203) 558-9865
Entity
Organization
Contact information
Practice address
60 N MAIN ST, 3RD FLR, WATERBURY, CT 06702-1443
(203) 558-9865
Mailing address
60 N MAIN ST, 3RD FLR, WATERBURY, CT 06702-1443
(203) 558-9865
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008042640
—
CT
Enumeration date
11/30/2015
Last updated
11/30/2015
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