| Progressive Life Center Inc. | |
|
1933 Montana Ave Ne Washington DC 20002-1817 | |
| (202) 842-2016 | |
| (202) 842-0604 |
| Full Name | Progressive Life Center Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1933 Montana Ave Ne, Washington, District Of Columbia |
| Authorized Official Name and Position | Tracy Ozzaline Garrett (DIRECTOR OF QI AND BHC) |
| Authorized Official Contact | 2028422016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Life Center Inc. 1704 17th St Ne Washington DC 20002-1810 Ph: (202) 842-2016 | Progressive Life Center Inc. 1933 Montana Ave Ne Washington DC 20002-1817 Ph: (202) 842-2016 |
| NPI Number | 1386786093 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386786093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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