Organization
PROGRESSIVE HABILITATIVE SERVICES INC. II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUDE-MARIE KOKER (C E O)
(301) 681-8312
Entity
Organization
Contact information
Practice address
6407 CHILLUM PL. N,W., WASHINGTON, DC 20012
(202) 291-3672
Mailing address
13629 BALTIMORE AVE, LAUREL, MD 20707-5095
(301) 317-9996
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038479400
—
DC
Enumeration date
01/11/2008
Last updated
04/21/2010
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