NPIMap

Organization Active NPI

Progressive Health of Pennsylvania Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Milford, PA
National Provider Identifier
1114063633
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PROGRESSIVE HEALTH OF PENNSYLVANIA INC.
Practice address
110 E Harford St
Milford, PA 18337-1002
Phone
(570) 296-5156
Fax
(570) 296-2592
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Mr. Paul Brooks
Title
Ceo
Phone
(570) 296-5156

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

110 E Harford St
Milford, PA 18337-1002

Mailing address

110 East Harford Street
Milford, PA 18337-1002
Phone (570) 296-5156

Other identifiers 1

IdentifierTypeStateIssuer
1006808200002MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1114063633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EAST HARFORD STREET",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183371002",
            "telephone_number": "570-296-5156",
            "fax_number": "570-296-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E HARFORD ST",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183371002",
            "telephone_number": "570-296-5156",
            "fax_number": "570-296-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE HEALTH OF PENNSYLVANIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-296-5156",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006808200002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.