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General NPI Number Information
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NPI Number | 1982490322
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HEALTH INC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 824 ASHBY DR
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City | MIDDLETOWN
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State | DE
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Zip | 19709-9951
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Country | US
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Telephone | 484-557-6793
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Fax |
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Provider Business Mailing Address
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Address Line | 525 W CHESTER PIKE STE 311A
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City | HAVERTOWN
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State | PA
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Zip | 19083-4510
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Country | US
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Telephone | 484-557-6793
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | FRIDAY ISOKPEHI OBASEIME
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Credential |
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Telephone | 610-789-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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