Organization
PROSPERA HEALTHCARE MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE CODDINGTON (COO)
(972) 900-2488
Entity
Organization
Contact information
Practice address
402 W 2ND ST, ROCHESTER, MI 48307-1904
(248) 770-9929
Mailing address
5200 SADDLE DR, FLOWER MOUND, TX 75028-6011
(972) 900-2488
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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