Provider Demographics
NPI:1023191376
Name:PROGRESSIVE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE HOME HEALTH SERVICES, INC.
Other - Org Name:KIND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:212-273-5500
Mailing Address - Street 1:90 BROAD STREET
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2297
Mailing Address - Country:US
Mailing Address - Phone:212-273-5500
Mailing Address - Fax:212-273-5476
Practice Address - Street 1:90 BROAD STREET
Practice Address - Street 2:10TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2297
Practice Address - Country:US
Practice Address - Phone:212-273-5500
Practice Address - Fax:212-273-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1348L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0212047803Medicaid