Healthcare Provider Details

I. General information

NPI: 1255966750
Provider Name (Legal Business Name): PROGRESS CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 09/28/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 S 24TH ST
PITTSBURGH PA
15203-2233
US

IV. Provider business mailing address

85 S 24TH ST
PITTSBURGH PA
15203-2233
US

V. Phone/Fax

Practice location:
  • Phone: 412-450-0118
  • Fax:
Mailing address:
  • Phone: 412-450-0118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: BRYAN KIGER
Title or Position: CEO
Credential:
Phone: 412-980-1697