Organization
PROSPERITY HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CIMILIEN STEPHENSON (OWNER)
(561) 888-9466
Entity
Organization
Contact information
Practice address
2615 NE 3RD ST, BOYNTON BEACH, FL 33435-2110
(561) 888-9466
Mailing address
2615 NE 3RD ST, BOYNTON BEACH, FL 33435-2110
(561) 888-9466
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L20000385918
LIMITED LIABILITY COMPANY
FL
Enumeration date
01/01/2021
Last updated
01/03/2021
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