Organization
THE PROGRESS PLACE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONICA ANGEL LOGAN (CEO)
(678) 894-0288
Entity
Organization
Contact information
Practice address
2302 PARKLAKE DR NE STE 415, ATLANTA, GA 30345-2896
(678) 894-0288
(336) 791-2188
Mailing address
2302 PARKLAKE DR NE STE 415, ATLANTA, GA 30345-2896
(678) 894-0288
(336) 791-2188
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
341600000X
Ambulance
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141957A
—
GA
05
—
3419164
—
NC
Enumeration date
04/14/2009
Last updated
08/31/2021
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