Organization
PROSPER HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHESTER LACKEY (OWNER)
(208) 757-0337
Entity
Organization
Contact information
Practice address
1345 HILINE RD, POCATELLO, ID 83201-2943
(208) 757-0337
Mailing address
675 JEFFERSON AVE # B, POCATELLO, ID 83201-3729
(208) 805-9503
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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