1982709507 NPI number — THE PROGRESS CENTER, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982709507 NPI number — THE PROGRESS CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE PROGRESS CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982709507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 COTTAGE STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWAY
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-743-8049
Provider Business Mailing Address Fax Number:
207-739-6110

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 COTTAGE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWAY
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-743-8049
Provider Business Practice Location Address Fax Number:
207-739-6110
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ANTHONY
Authorized Official First Name:
DEB
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
207-743-8049

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , with the licence number: ALLS 2094 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , with the licence number: ALLS817 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , with the licence number: ALLS 627 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110670203 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670101 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670201 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670400 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670300 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670001 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670200 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110670100 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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