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NPI Code Detail

MEDICARE: PROGRESSIVE INTERVENTIONS, INC.

MEDICARE: PROGRESSIVE INTERVENTIONS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2251S00000XCommunity/Behavioral Health Agency
3261QM0850XAdult Mental Health Clinic/Center
4261QM0855XAdolescent and Children Mental Health Clinic/Center
5261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1437305331
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROGRESSIVE INTERVENTIONS, INC.
Provider Business Mailing Address
First Line : 800 N MANGUM ST
Second Line : SUITE 111B
City : DURHAM
State : NC
Zip : 27701-2260
Country : US
Telephone Number : 919-519-7757
Fax Number :
Provider Business Practice Location Address
First Line : 800 N MANGUM ST
Second Line : SUITE 111B
City : DURHAM
State : NC
Zip : 27701-2260
Country : US
Telephone Number : 919-519-7757
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. IVORY C THOMPSON
Credential : BSW
Telephone Number : 919-519-7757
Provider Enumeration Date : 08/11/2008
Last Update Date : 09/10/2008

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Directions to “PROGRESSIVE INTERVENTIONS, INC. ” Practice Location

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