Organization
PROSPERITY HAVEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEIR KASNETT (OWNER)
(216) 372-6643
Entity
Organization
Contact information
Practice address
9600 OLD STATE RD, CHARDON, OH 44024-9260
(859) 652-2771
Mailing address
9600 OLD STATE RD, CHARDON, OH 44024-9260
(440) 285-2762
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0312566
—
OH
Enumeration date
10/30/2017
Last updated
11/09/2019
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