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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