Prospera Healthcare ABA LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROSPERA HEALTHCARE ABA LLC

Practice address

5200 Saddle Dr
Flower Mound, TX 75028-6011

Phone

(972) 900-2488

NPI assigned

Nov 23, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kyle Coddington

Title

Coo

Phone

(972) 400-1983

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1174280283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SADDLE DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750286011",
            "telephone_number": "972-900-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SADDLE DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750286011",
            "telephone_number": "972-900-2488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 W Spruce St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336072553",
            "country_code": "US",
            "telephone_number": "972-900-2488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROSPERA HEALTHCARE ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "CODDINGTON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "972-400-1983"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.