Organization
PROSPER DDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BERGER (ACCOUNT ADMINISTRATOR)
(208) 270-1309
Entity
Organization
Contact information
Practice address
4043 E 530 N, RIGBY, ID 83442-4948
(208) 270-1309
Mailing address
4043 E 530 N, RIGBY, ID 83442-4948
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
03/17/2022
Last updated
03/17/2026
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