Provider Demographics
NPI: | 1992969133 |
---|---|
Name: | PROGRESSIVE MILESTONES CORPORATION |
Entity type: | Organization |
Organization Name: | PROGRESSIVE MILESTONES CORPORATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KIMBERLY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SULAIMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MOT,OTR/L |
Authorized Official - Phone: | 832-675-9704 |
Mailing Address - Street 1: | 5600 NW CENTRAL DR STE 213 |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77092-2078 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 832-675-9704 |
Mailing Address - Fax: | 888-859-0849 |
Practice Address - Street 1: | 5600 NW CENTRAL DR STE 213 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77092-2078 |
Practice Address - Country: | US |
Practice Address - Phone: | 832-675-9704 |
Practice Address - Fax: | 888-859-0849 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-07-16 |
Last Update Date: | 2022-08-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health | Group - Multi-Specialty | |
No | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities | Group - Multi-Specialty |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health |