| Organization Name: | PROSPER AT HOME HEALTH CARE SERVICES LLC |
| NPI Number: | 1215385463 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHAWANDA LESTER SPENCER (MANAGING DIRECTOR/HEAD NP) |
| Mailing Address: | 7319 Yellowhorn Trl Waxhaw |
| State: | NC US |
| Postal Code: | 281737465 |
| Phone Number: | 7049070537 |
| Fax Number: | |
| NPI Enumeration Date: | 05/27/2016 |
| NPI Last Update Date: | 05/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F0516317 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |