Organization
PROSPERITY RISING HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYANT BETTEZ (CHIEF FINANCIAL OFFICER)
(603) 289-7047
Entity
Organization
Contact information
Practice address
1650 W ROSEDALE ST STE 307, FORT WORTH, TX 76104-7400
(603) 289-7047
Mailing address
1650 W ROSEDALE ST STE 307, FORT WORTH, TX 76104-7400
(682) 703-9355
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
04/30/2024
Last updated
05/15/2025
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