Organization
PROGRESSIVE COMMUNITY HEALTH CENTERS, INC
Active
Organization
PROGRESSIVE COMMUNITY HEALTH CENTERS, INC
Active
Other names
Hillside Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDICE COLE (CFO)
(414) 935-8000
Entity
Organization
Contact information
Practice address
1452 N 7TH ST, 2ND FLOOR, MILWAUKEE, WI 53205-2301
(414) 935-8000
Mailing address
PO BOX 080257, MILWAUKEE, WI 53208-8004
(414) 935-8000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207QA0505X
Adult Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32957400
—
WI
Enumeration date
09/23/2010
Last updated
01/25/2017
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