Provider Demographics
NPI:1134410327
Name:POSITIVE PROGRESS SERVICES CORP.
Entity type:Organization
Organization Name:POSITIVE PROGRESS SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:910-521-7461
Mailing Address - Street 1:305 E 3RD ST STE 5
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7991
Mailing Address - Country:US
Mailing Address - Phone:910-521-7461
Mailing Address - Fax:910-521-7463
Practice Address - Street 1:305 E 3RD ST
Practice Address - Street 2:SUITE #5
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-7991
Practice Address - Country:US
Practice Address - Phone:910-521-7461
Practice Address - Fax:910-521-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-078-249101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1477604007Medicaid
NC1063618049Medicaid
NC1770689101Medicaid
NC1134225154Medicaid
NC1760607006Medicaid