| Progressive Community Services, Llc | |
|
123 S Adams St Petersburg VA 23803-4526 | |
| (804) 861-5003 | |
| (804) 861-5000 |
| Full Name | Progressive Community Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 123 S Adams St, Petersburg, Virginia |
| Authorized Official Name and Position | Aaron Lindsay Knight (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8043070497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Community Services, Llc 123 S Adams St Petersburg VA 23803-4526 Ph: (804) 861-5003 | Progressive Community Services, Llc 123 S Adams St Petersburg VA 23803-4526 Ph: (804) 861-5003 |
| NPI Number | 1568116440 |
|---|---|
| Provider Enumeration Date | 02/09/2022 |
| Last Update Date | 02/09/2022 |
| Certification Date | 02/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568116440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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