| Prospect Supportive Care Inc | |
|
19743 Blacksmith Path Corona CA 92881-4153 | |
| (657) 282-2888 | |
| Not Available |
| Full Name | Prospect Supportive Care Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 19743 Blacksmith Path, Corona, California |
| Authorized Official Name and Position | Alfredo Rodrigo Lujan Perales (PRESIDENT/CEO) |
| Authorized Official Contact | 6572822888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospect Supportive Care Inc 473 N Bloomberry Unit A Orange CA 92869-7552 Ph: (657) 282-2888 | Prospect Supportive Care Inc 19743 Blacksmith Path Corona CA 92881-4153 Ph: (657) 282-2888 |
| NPI Number | 1801739776 |
|---|---|
| Provider Enumeration Date | 04/14/2026 |
| Last Update Date | 04/14/2026 |
| Certification Date | 04/14/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801739776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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