Provider Demographics
NPI:1225398076
Name:NEW PROGRESSIONS OF NEVADA
Entity Type:Organization
Organization Name:NEW PROGRESSIONS OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOVON
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:336-254-6770
Mailing Address - Street 1:620-G GUILFORD COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2027
Mailing Address - Country:US
Mailing Address - Phone:336-254-6770
Mailing Address - Fax:
Practice Address - Street 1:5940 S. RAINBOW BLVD.
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118
Practice Address - Country:US
Practice Address - Phone:336-254-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health