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Organization

PROSPER AZ

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELONDA WILSON (ADMINISTRATOR)
(602) 899-3015
Entity
Organization

Contact information

Practice address
10750 W MCDOWELL RD, AVONDALE, AZ 85392-5960
(602) 899-3015
Mailing address
10750 W MCDOWELL RD STE C301, AVONDALE, AZ 85392-5964
(623) 755-5679

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
10/08/2020
Last updated
10/27/2021
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