Organization
PROGRESSIVE HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON JOSEPH DAVEZAC (COO/OWNER)
(225) 654-1560
Entity
Organization
Contact information
Practice address
12038 GREENWELL SPRINGS PORT HUDSON RD, ZACHARY, LA 70791
(225) 654-1560
(225) 654-9574
Mailing address
PO BOX 1339, ZACHARY, LA 70791-1339
(225) 654-1560
(225) 654-9574
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1900606052
BLUE CROSS BLUE SHIELD
LA
Enumeration date
08/10/2005
Last updated
01/20/2010
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