Provider Demographics
NPI:1538345582
Name:PROGRESSIVE HOMECARE SERVICES INC.
Entity type:Organization
Organization Name:PROGRESSIVE HOMECARE SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROGRAM
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:ONYEBUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-657-5209
Mailing Address - Street 1:1269 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5901
Mailing Address - Country:US
Mailing Address - Phone:734-657-5209
Mailing Address - Fax:734-975-2984
Practice Address - Street 1:1269 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5901
Practice Address - Country:US
Practice Address - Phone:734-657-5209
Practice Address - Fax:734-975-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-20
Last Update Date:2008-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home