Organization
PROGRESSIVE HOMECARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDDIA GETAWERU (CEO/OWNER)
(480) 773-8480
Entity
Organization
Contact information
Practice address
45720 W TUCKER RD, MARICOPA, AZ 85139-6642
(480) 773-8480
(480) 546-3626
Mailing address
18585 N FALCON LN, MARICOPA, AZ 85138-3756
(480) 773-8480
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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