| Progressive Recovery Resources Llc | |
|
1801 N Tryon St Ste 325 Charlotte NC 28206-2704 | |
| (704) 891-6404 | |
| (980) 225-0560 |
| Full Name | Progressive Recovery Resources Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1801 N Tryon St Ste 325, Charlotte, North Carolina |
| Authorized Official Name and Position | Ameer Green (EXECUTIVE DIRECTOR/OWNER) |
| Authorized Official Contact | 7048916404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Recovery Resources Llc 1801 N Tryon St Ste 325 Charlotte NC 28206-2704 Ph: (704) 891-6404 | Progressive Recovery Resources Llc 1801 N Tryon St Ste 325 Charlotte NC 28206-2704 Ph: (704) 891-6404 |
| NPI Number | 1437491248 |
|---|---|
| Provider Enumeration Date | 03/19/2013 |
| Last Update Date | 03/19/2013 |
| Medicare PECOS PAC ID | 4183886724 |
|---|---|
| Medicare Enrollment ID | O20130603000559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437491248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C005677 (North Carolina) | Primary |
| Provider Name | Delores Estelle Burrill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750532461 PECOS PAC ID: 6204127087 Enrollment ID: I20160627000259 |
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