Healthcare Provider Details

I. General information

NPI: 1942468871
Provider Name (Legal Business Name): POSITIVE PROGRESS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 EAST THIRD STREET STE 5
PEMBROKE NC
28737-8372
US

IV. Provider business mailing address

P O BOX 1678
PEMBROKE NC
28372-8372
US

V. Phone/Fax

Practice location:
  • Phone: 910-843-5021
  • Fax: 910-843-5021
Mailing address:
  • Phone: 910-843-5021
  • Fax: 910-843-5021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS LORIE HAMMONDS
Title or Position: DIRECTOR
Credential:
Phone: 910-734-6765