Provider Demographics
NPI:1063046159
Name:PROGRESSIVE STEPS FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:PROGRESSIVE STEPS FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QMHP
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SHAW
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-386-2540
Mailing Address - Street 1:700 LOMBARDY AVE APT 7413
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3368
Mailing Address - Country:US
Mailing Address - Phone:757-386-2540
Mailing Address - Fax:
Practice Address - Street 1:700 LOMBARDY AVE APT 7413
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3368
Practice Address - Country:US
Practice Address - Phone:757-386-2540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services