| Progressive Recovery Resources Llc | |
|
3129 Creighton Dr Charlotte NC 28205-6209 | |
| (704) 891-6404 | |
| Not Available |
| Full Name | Progressive Recovery Resources Llc |
|---|---|
| Speciality | Case Management |
| Location | 3129 Creighton Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Ameer Green (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7048916404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Recovery Resources Llc 3129 Creighton Dr Charlotte NC 28205-6209 Ph: (704) 891-6404 | Progressive Recovery Resources Llc 3129 Creighton Dr Charlotte NC 28205-6209 Ph: (704) 891-6404 |
| NPI Number | 1144456104 |
|---|---|
| Provider Enumeration Date | 06/04/2009 |
| Last Update Date | 04/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144456104 | NPI | - | NPPES |
| 8700569 | Medicaid | NC | |
| 7001430 | Medicaid | NC | |
| 6008234 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (North Carolina) | Secondary |
| 251B00000X | Case Management | (North Carolina) | Primary |
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