Organization
PROSPERITY'SHOUSECOMMUNITYSVS.INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PINKIE GRAYSON BROOME BSINSOCIALWORK (DIRECTOR)
(225) 273-4013
Entity
Organization
Contact information
Practice address
514 TRAMMELL DR, BATON ROUGE, LA 70815-6940
(225) 273-4013
(225) 273-4013
Mailing address
514 TRAMMELL DR, BATON ROUGE, LA 70815-6940
(225) 273-4013
(225) 273-4013
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
11022
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11022
—
LA
Enumeration date
05/22/2008
Last updated
05/22/2008
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