| Progressive Recovery Llc | |
|
8310 Carob Tree Ln Charlotte NC 28215-7142 | |
| (917) 767-9817 | |
| Not Available |
| Full Name | Progressive Recovery Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8310 Carob Tree Ln, Charlotte, North Carolina |
| Authorized Official Name and Position | Latisha Coles (AGENCY DIRECTOR) |
| Authorized Official Contact | 9177679817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Recovery Llc 5309 Monroe Rd Ste 112 Charlotte NC 28205-7829 Ph: (917) 767-9817 | Progressive Recovery Llc 8310 Carob Tree Ln Charlotte NC 28215-7142 Ph: (917) 767-9817 |
| NPI Number | 1053076364 |
|---|---|
| Provider Enumeration Date | 11/02/2021 |
| Last Update Date | 01/05/2022 |
| Certification Date | 01/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053076364 | NPI | - | NPPES |
| 00000 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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