Provider Demographics
NPI:1952568719
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:MR
Authorized Official - First Name:HARSH
Authorized Official - Middle Name:DIGAMBER
Authorized Official - Last Name:SHENDE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:443-991-5907
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:
Practice Address - Street 1:7801 YORK RD
Practice Address - Street 2:SUITE 224
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7446
Practice Address - Country:US
Practice Address - Phone:443-991-5907
Practice Address - Fax:443-548-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation