Provider Demographics
NPI:1629491030
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:
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 1:415 MORGNEC RD
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1046
Practice Address - Country:US
Practice Address - Phone:410-778-1900
Practice Address - Fax:443-548-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation