Provider Demographics
NPI:1912025271
Name:PROGRESS REHABILITATION, INC.
Entity Type:Organization
Organization Name:PROGRESS REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARBOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-897-0007
Mailing Address - Street 1:169 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-4608
Mailing Address - Country:US
Mailing Address - Phone:508-897-0007
Mailing Address - Fax:508-897-0020
Practice Address - Street 1:169 COURT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-4608
Practice Address - Country:US
Practice Address - Phone:508-897-0007
Practice Address - Fax:508-897-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty