Organization
PROSPER ADOLESCENT CARE LLC
Active
Other names
Prosper Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAM BAISDEN JR. (PARTNER)
(406) 890-5885
Entity
Organization
Contact information
Practice address
31733 S FORK YAAK RD STE B, TROY, MT 59935-8681
(855) 383-2566
Mailing address
6885 BAUMAN ST, BONNERS FERRY, ID 83805-8723
(855) 383-2566
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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