PROSPERITY WELLNESS CENTER
NPI 1972634939
Substance Abuse Rehabilitation Facility in Tacoma, WA
- Organization
- Substance Abuse Rehabilitation Facility
- CLIA Number: 50D2104237
- CLIA Cert. Type: Other - DRUG TREATMENT
- CLIA Exp. Date: 04-04-2028
About PROSPERITY WELLNESS CENTER
This page provides the complete NPI Profile along with additional information for Prosperity Wellness Center, a provider established in Tacoma, Washington operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1972634939 assigned on March 2007. The practitioner's primary taxonomy code is 324500000X with license number RTF1042 (WA). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Prosperity Wellness Center. The authorized official of this NPI record is Magdalen Gustilo (Director Of Payer Relations)
- NPI
- 1972634939 Verify this NPI
- Provider Legal Name
- PROSPERITY COUNSELING & TREATMENT SVCS
- Other Organization Name
- PROSPERITY WELLNESS CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 5001 112TH ST E TACOMA, WA 98446
- Location Phone
- (714) 828-1800
- Location Fax
- (714) 882-1186
- Mailing Address
- 18401 VON KARMAN AVE STE 500 IRVINE, CA 92612
- Mailing Phone
- (714) 828-1800
- Mailing Fax
- (714) 882-1186
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-08-2007
- Last Update Date
- 05-08-2023
- Code Navigator
Location Map
Secondary Locations
- 12201 Pacific Ave S
Tacoma, WA 98444
(714) 828-1800
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Substance Abuse Rehabilitation Facility
- Taxonomy Code
- 324500000X
- Type
- Residential Treatment Facilities
- License No.
- RTF1042
- License State
- WA
- Taxonomy Description
- 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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 50D2104237
- Facility Type
- Other - DRUG TREATMENT
- Certificate Effective Date
- October 30, 2015
- Certificate Expiration Date
- April 04, 2028
- Laboratory Director
- LAURA POCI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Prosperity Wellness Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 12 providers are registered at the same or a nearby location.
TACOMA, WA 98446
TACOMA, WA 98446
TACOMA, WA 98446
TACOMA, WA 98446
TACOMA, WA 98446
TACOMA, WA 98446
TACOMA, WA 98446
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972634939, enumerated as an "organization" on March 08, 2007.
The provider is located at 5001 112TH ST E TACOMA, WA 98446 and the phone number is (714) 828-1800.
Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
