Progressive Health Care Providers/fern Park, LLC

NPI #1447259254 in Fern Park, Florida

Provider Information

NPI Number
1447259254
Entity Type
Organization
Organization Name
Progressive Health Care Providers/fern Park, LLC
Primary Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Jul 14, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
230 FERN PARK BLVD
State
Florida
ZIP Code
32730-2500
Phone
(407) 331-7231

Authorized Official

Name
MR. TERRY REVELL
Title
ADMINISTRATOR
Phone
(407) 331-7231

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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