Prosperin 21 St LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROSPERIN 21 ST LLC

Practice address

301 Edgewater PL
Wakefield, MA 01880-1293

Phone

(781) 856-0539

Fax

(781) 584-6983

NPI assigned

Jan 30, 2015

Organization subpart

Yes

Parent organization

PROSPERIN 21 ST LLCAs reported in NPPES

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

Authorized official

Name

Jeannette Mukandori Ndahunga, LPN

Title

President/ Secretary

Phone

(781) 856-0539

Specialties & licenses 1

Addresses

Other names 1

• Healthbridge Home Care Solutions Doing business as

Part of

Prosperin 21 St LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Prosperin 21 St LLC

  • Home Health Agency
  • Lynn, MA
  • NPI 1982064960
  NPPES parent name

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1902296783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EDGEWATER PLACE",
            "address_2": "SUITE 100",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018806234",
            "telephone_number": "781-842-3035",
            "fax_number": "781-584-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EDGEWATER PL",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801293",
            "telephone_number": "781-856-0539",
            "fax_number": "781-584-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERIN 21 ST LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROSPERIN 21 ST LLC",
        "enumeration_date": "2015-01-30",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "NDAHUNGA",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_middle_name": "MUKANDORI",
        "authorized_official_title_or_position": "PRESIDENT/ SECRETARY",
        "authorized_official_telephone_number": "781-856-0539",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthbridge Home Care Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Virginia Prechtl, DPM
• Heeralakshmi Prem
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• Prevention Partners, LLC
• Colleen Prinzivalli, PHARMD, BCPS, BCGP
• Colleen Marie Quinn, LMT
• Maura A Racamato
• Kristen Kay Radlinski, LICSW
• Raffaele a Petrosino
• Hilary Anne Rao, MSW

• Home Health Agency in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.