Provider Demographics
NPI:1316359938
Name:PROGRESSIVE REHAB SERVICES
Entity Type:Organization
Organization Name:PROGRESSIVE REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HARSH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHENDE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:410-312-7631
Mailing Address - Street 1:10015 OLD COLUMBIA RD
Mailing Address - Street 2:SUITE B 215
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1703
Mailing Address - Country:US
Mailing Address - Phone:410-312-7631
Mailing Address - Fax:410-510-1779
Practice Address - Street 1:1111 E COLD SPRING LN
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-3932
Practice Address - Country:US
Practice Address - Phone:410-323-0500
Practice Address - Fax:443-548-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07558235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty