Provider Demographics
NPI:1518176312
Name:PROGRESSIVE HEALTH MANAGEMENT INC.
Entity Type:Organization
Organization Name:PROGRESSIVE HEALTH MANAGEMENT INC.
Other - Org Name:BAYCARE INVERNESS AND BAYCARE HEALTH MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-400-4770
Mailing Address - Street 1:957 S US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-6712
Mailing Address - Country:US
Mailing Address - Phone:352-400-4770
Mailing Address - Fax:352-344-4931
Practice Address - Street 1:957 S US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450-6712
Practice Address - Country:US
Practice Address - Phone:352-400-4770
Practice Address - Fax:352-344-4931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1309AD6112101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty