Organization
PROGRESSIVE HABILITATIVE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAUDE MARIE KOKER (PRESIDENT CEO)
(301) 317-9996
Entity
Organization
Contact information
Practice address
13629 BALTIMORE AVE, LAUREL, MD 20707-5095
(301) 317-9996
(301) 317-9988
Mailing address
545 8TH ST SE, WASHINGTON, DC 20003-2897
(202) 544-9057
(202) 544-9059
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035555200
—
DC
Enumeration date
04/23/2007
Last updated
04/21/2010
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