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General NPI Number Information
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NPI Number | 1063046159
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE STEPS FAMILY SERVICES LLC
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 700 LOMBARDY AVE APT 7413
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-3368
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Country | US
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Telephone | 757-386-2540
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Fax |
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Provider Business Mailing Address
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Address Line | 700 LOMBARDY AVE APT 7413
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-3368
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Country | US
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Telephone | 757-386-2540
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Fax |
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Authorized Official
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Title or Position | QMHP
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Name | MS. KIMBERLY SHAW TAYLOR
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Credential |
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Telephone | 757-386-2540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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