PROSPEROUS HEALTH IMPERIAL BEACH, LLC
NPI 1124826011
Substance Abuse Rehabilitation Facility in Imperial Beach, CA

Q: What is Prosperous Health Imperial Beach, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Active since March 05, 2025

107 DAISY AVE, IMPERIAL BEACH, CA 91932(833) 364-4722 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 23, 2025, Mar 5, 2025 (2 updates tracked since 2025).

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About Prosperous Health Imperial Beach, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROSPEROUS HEALTH IMPERIAL BEACH, LLC (NPI 1124826011) is a healthcare organization registered as a substance abuse rehabilitation facility in Imperial Beach, California and active in the NPI registry since March 2025. The organization maintains a secondary practice location in Imperial Beach and lists Jerry Shirey, President, as its authorized official.

NPPES Registry Identity

NPI1124826011

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NamePROSPEROUS HEALTH IMPERIAL BEACH, LLC

Location Address107 DAISY AVEImperial Beach, CA 91932

Mailing Address9909 Huennekens St Ste 110San Diego, CA 92121-2928

Phone(833) 364-4722

Organization SubpartNo

Authorized OfficialJerry ShireyPresident · (619) 669-3295

Enumeration DateMarch 5, 2025

Last NPPES UpdateJune 23, 20252 updates tracked since enumeration

NPPES CertifiedJune 2, 2025

✔ NPI 1124826011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X

107 DAISY AVE, Imperial Beach, CA 91932

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Secondary Practice Location 1

Location 1109 Daisy AveImperial Beach, CA 91932 · Phone (833) 364-4722

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prosperous Health Imperial Beach, LLC's NPI number?

The NPI number for Prosperous Health Imperial Beach, LLC is 1124826011. It was assigned to this organization in the NPPES registry on March 5, 2025.

Where is Prosperous Health Imperial Beach, LLC located?

Prosperous Health Imperial Beach, LLC is located at 107 Daisy Ave, Imperial Beach, CA 91932. The listed phone number is (833) 364-4722.

What is Prosperous Health Imperial Beach, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Prosperous Health Imperial Beach, LLC was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.