NPI | 1326379926 |
---|---|
Former Legal Business Name | PROGRESSIVE MEDICAL SPECIALISTS INC |
Entity Type | Organization |
Authorized Contact | CHRISTOPHER BLAKE O'ROURKE Program Director 619-286-4600 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 37-19) |
Enumeration Date | 2010-01-21 |
Last Update Date | 2020-10-30 |