OrganizationActive
Elite Residential for Matured Adults
NPI 1083865141 · Physical Disabilities Residential Treatment Facility · Prosper, TX
Provider details
- NPI number
- 1083865141
- Entity type
- Organization
- Primary specialty
- Physical Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Vikkilynn Prevost, Co-Owner/Director(972) 347-6035
Specialties & taxonomies
Residential Treatment Facilities
Practice location
160 Wilson Dr
Prosper, TX 75078-8580
Phone: (972) 347-6035
Fax: (972) 347-6250
Approximate (ZIP-level) locationGet directions
Mailing address
160 Wilson Dr
Prosper, TX 75078-8580
Registry dates
- Enumerated
- 2008-10-08
- Last updated
- 2008-10-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.