| Prospera Healthcare Michigan Llc | |
|
402 W 2nd St Rochester MI 48307-1904 | |
| (248) 770-9929 | |
| Not Available |
| Full Name | Prospera Healthcare Michigan Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 402 W 2nd St, Rochester, Michigan |
| Authorized Official Name and Position | Kyle Coddington (COO) |
| Authorized Official Contact | 9729002488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospera Healthcare Michigan Llc 5200 Saddle Dr Flower Mound TX 75028-6011 Ph: (972) 900-2488 | Prospera Healthcare Michigan Llc 402 W 2nd St Rochester MI 48307-1904 Ph: (248) 770-9929 |
| NPI Number | 1255002812 |
|---|---|
| Provider Enumeration Date | 09/23/2021 |
| Last Update Date | 09/23/2021 |
| Certification Date | 09/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255002812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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