Progressive Alternative Living, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

8530834180 Issued in MO

Legal business name

PROGRESSIVE ALTERNATIVE LIVING, INC.

Practice address

410 W Broadway St
Higginsville, MO 64037-1947

Phone

(660) 584-2199

Fax

(660) 584-3199

NPI assigned

Apr 30, 2008

Last updated

Jul 22, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Terri A. Marr

Title

Director

Phone

(660) 584-2199

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PAL Other name

Tax ID family

Pal2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Progressive Alternative Living, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Higginsville, MO
  • NPI 1487771440
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1093981052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W BROADWAY ST",
            "city": "HIGGINSVILLE",
            "state": "MO",
            "postal_code": "640371947",
            "telephone_number": "660-584-2199",
            "fax_number": "660-584-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W BROADWAY ST",
            "city": "HIGGINSVILLE",
            "state": "MO",
            "postal_code": "640371947",
            "telephone_number": "660-584-2199",
            "fax_number": "660-584-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE ALTERNATIVE LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "MARR",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "660-584-2199",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MO",
            "license": "8530834180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853083418",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853083400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andrew Michael Penner, PLPC
• Roger Leslie Petersen, OD
• Physical Therapy of Higginsville
• Plattner Dental Associates, LLC (Plattner Dentistry Family & Cosmetic)
• Progressive Alternative Living, Inc
• Mary E. Pugh, LCSW
• David V Pulliam, D.O.
• Robert Rauch
• Red Cross Pharmacy, Inc (Red Cross LTC Pharmacy)
• Matthew David Rhadans, M.D.

• Intellectual Disabilities Intermediate Care Facility in Higginsville, MO
• Providers in Higginsville, MO by specialty
• Intellectual Disabilities Intermediate Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.