Provider Demographics
NPI:1629773296
Name:PROGRESSIVE PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:PROGRESSIVE PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUCKINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-801-9688
Mailing Address - Street 1:8532 W LISBON AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-3729
Mailing Address - Country:US
Mailing Address - Phone:414-801-9688
Mailing Address - Fax:
Practice Address - Street 1:8532 W LISBON AVE STE 4
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-3729
Practice Address - Country:US
Practice Address - Phone:414-801-9688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care