Basic Information
| Provider Information | |||||||||
| NPI: | 1497017024 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PROGRESSIVE STAFFING INCORPORATED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10015 OLD COLUMBIA RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210461703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103127631 | ||||||||
| FaxNumber: | 4103127632 | ||||||||
| Practice Location | |||||||||
| Address1: | 10015 OLD COLUMBIA RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210461703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103127631 | ||||||||
| FaxNumber: | 4103127632 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2012 | ||||||||
| LastUpdateDate: | 06/11/2012 | ||||||||
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| AuthorizedOfficialLastName: | SHENDE | ||||||||
| AuthorizedOfficialFirstName: | HARSH | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4103127631 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | OTR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 04531 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.