Progressive Institute LLC
Clinic/Center, Rehabilitation, Substance Use Disorder in Shelton, CT. Organization (NPI-2).
NPI number1669944724
StatusActive
Last updated in NPPESSep 8, 2020
Details
- NPI
- 1669944724
- Entity type
- Organization (NPI-2)
- Legal business name
- Progressive Institute LLC
- Organization subpart
- No
- Enumeration date
- Dec 28, 2018
- Certification date
- Sep 8, 2020
- Last updated
- Sep 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
Practice location
2 Trap Falls Rd Ste 120Shelton, CT 06484-4616
Phone 203-816-6424 · Fax 630-522-0843
Mailing address
2 Trap Falls Rd Ste 120Shelton, CT 06484-4616
Phone 203-816-6424 · Fax 203-513-8474
Authorized official
Greg Gillam
Director Of Operations
2038166424
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