Organization
PROGRESSIVE INTELLECTUAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAMONTE S OWENS (OWNER)
(301) 318-8984
Entity
Organization
Contact information
Practice address
208 JOCKEY HOLLOW RUN, SWEDESBORO, NJ 08085-3042
(301) 318-8984
Mailing address
208 JOCKEY HOLLOW RUN, SWEDESBORO, NJ 08085-3042
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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