Prosper Health LLC

Primary specialty

Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X

Legal business name

PROSPER HEALTH LLC

Practice address

1345 Hiline Rd
Pocatello, ID 83201-2943

Phone

(208) 757-0337

NPI assigned

May 21, 2024

Last updated

May 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chester Lackey

Title

Owner

Phone

(208) 757-0337

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1407695224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 JEFFERSON AVE # B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013729",
            "telephone_number": "208-805-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 HILINE RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012943",
            "telephone_number": "208-757-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPER HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-757-0337"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Hospital Unit in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Substance Use Disorder Rehabilitation Hospital Unit in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.