Organization
PROSPEROUS BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FANETTE PROSPERE NP (PMHNP/OWNER)
(954) 338-9738
Entity
Organization
Contact information
Practice address
4309 W ATLANTIC BLVD APT 917, COCONUT CREEK, FL 33066-1758
(954) 338-9738
Mailing address
5379 LYONS RD # 1860, COCONUT CREEK, FL 33073-2810
(954) 338-9738
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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