| Prosper Az | |
|
10750 W Mcdowell Rd Avondale AZ 85392-5960 | |
| (602) 899-3015 | |
| Not Available |
| Full Name | Prosper Az |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10750 W Mcdowell Rd, Avondale, Arizona |
| Authorized Official Name and Position | Elonda Wilson (ADMINISTRATOR) |
| Authorized Official Contact | 6028993015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosper Az 10750 W Mcdowell Rd Ste C301 Avondale AZ 85392-5964 Ph: (623) 755-5679 | Prosper Az 10750 W Mcdowell Rd Avondale AZ 85392-5960 Ph: (602) 899-3015 |
| NPI Number | 1982201299 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 10/27/2021 |
| Certification Date | 10/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982201299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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