NPIMap

Organization Active NPI

Progressive Housing, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • East Peoria, IL
National Provider Identifier
1104983493
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
0038240 Issued in IL
Legal business name
PROGRESSIVE HOUSING, INC.
Practice address
209 Harris Rd
East Peoria, IL 61611-4836
Phone
(309) 698-9600
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rob Keime
Title
Cfo
Phone
(309) 685-0595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 0038240 IL Primary

Addresses

Primary practice location

209 Harris Rd
East Peoria, IL 61611-4836

Mailing address

2020 W War Memorial Dr
Suite 103
Peoria, IL 61614-6754
Phone (309) 685-0595

Other names 1

  • Harris Place Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G294

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HARRIS PLACE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 16, 1993
Last certification
Mar 19, 2025
Beds
16
Ownership / control type
Private (non-profit)
Facility address
209 Harris Road
East Peoria, IL 61611

National Provider Directory

National Provider Directory
Tax ID family
Progressive Housing Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

2020 W War Memorial Dr
Ste 103
Peoria, IL 61614

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104983493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W WAR MEMORIAL DR",
            "address_2": "SUITE 103",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616146754",
            "telephone_number": "309-685-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HARRIS RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114836",
            "telephone_number": "309-698-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE HOUSING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEIME",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "309-685-0595"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0038240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harris Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Peoria, IL

Sources for this page

Verify at the official NPI Registry.