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General NPI Number Information
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NPI Number | 1477198760
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE SERVICES OF VIRGINIA LLC
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 5040 VIRGINIA BEACH BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6637
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Country | US
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Telephone | 757-343-9573
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Fax | 757-257-0544
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Provider Business Mailing Address
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Address Line | 5040 VIRGINIA BEACH BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6637
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Country | US
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Telephone | 757-343-9573
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Fax | 757-257-0544
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. GEORGIANA SMITH
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Credential | B.A, MHA
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Telephone | 757-343-9573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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