Organization
PROSPERITY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEONDRA ROCHELLE HARDEMON (CEO)
(713) 434-7700
Entity
Organization
Contact information
Practice address
4006 RIPPLEBROOK DR, HOUSTON, TX 77045-5518
(713) 434-7700
(713) 434-7703
Mailing address
4006 RIPPLEBROOK DR, HOUSTON, TX 77045-5518
(713) 434-7700
(713) 434-7703
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
270912557
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982889655
HOME COMMUNITY BASED SERVICE PROVIDER
TX
Enumeration date
04/10/2012
Last updated
04/10/2012
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