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General NPI Number Information
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NPI Number | 1750257382
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HOMECARE SERVICE LLC
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1303 PUNHOQUA ST
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City | OSHKOSH
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State | WI
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Zip | 54902-2642
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Country | US
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Telephone | 646-744-4838
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Fax | 646-744-4838
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Provider Business Mailing Address
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Address Line | 1303 PUNHOQUA ST
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City | OSHKOSH
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State | WI
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Zip | 54902-2642
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Country | US
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Telephone | 646-744-4838
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Fax | 646-744-4838
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | BUBA BOJANG
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Credential |
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Telephone | 646-744-4838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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