Provider Demographics
NPI:1295438141
Name:PROGRESSIVE PEER PARTNERS LLC
Entity type:Organization
Organization Name:PROGRESSIVE PEER PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIQUILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-894-7396
Mailing Address - Street 1:4101 FRYE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1696
Mailing Address - Country:US
Mailing Address - Phone:804-894-7396
Mailing Address - Fax:
Practice Address - Street 1:4101 FRYE CT
Practice Address - Street 2:
Practice Address - City:SOUTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23834-1696
Practice Address - Country:US
Practice Address - Phone:804-894-7396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health