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General NPI Number Information
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NPI Number | 1508025776
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HOME CARE, INC.
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 744 BROAD ST SUITE 1005
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City | NEWARK
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State | NJ
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Zip | 07102-3802
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Country | US
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Telephone | 973-622-2321
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Fax | 973-622-2328
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Provider Business Mailing Address
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Address Line | 744 BROAD ST SUITE 1005
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City | NEWARK
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State | NJ
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Zip | 07102-3802
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Country | US
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Telephone | 973-622-2321
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Fax | 973-622-2328
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Authorized Official
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Title or Position | DIR OF OPERATIONS
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Name | MR. DANNY LEE SMITH II
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Credential |
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Telephone | 973-622-2321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HP0116700
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License Number State | NJ
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