Provider Demographics
NPI:1508025776
Name:PROGRESSIVE HOME CARE, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:973-622-2321
Mailing Address - Street 1:744 BROAD ST
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-3802
Mailing Address - Country:US
Mailing Address - Phone:973-622-2321
Mailing Address - Fax:973-622-2328
Practice Address - Street 1:744 BROAD ST
Practice Address - Street 2:SUITE 1005
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3802
Practice Address - Country:US
Practice Address - Phone:973-622-2321
Practice Address - Fax:973-622-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0116700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health