Progressive Adult Rehabilitation Center, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

PROGRESSIVE ADULT REHABILITATION CENTER, INC.

Practice address

114 North Union Street
Suite B
Petersburg, VA 23803

Phone

(804) 732-0685

Fax

(804) 732-4988

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Felicia B Daniels, MSW

Title

Executive Director

Phone

(804) 732-0685

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1154473155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2085",
            "address_2": "114 NORTH UNION STREET SUITE B",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23803",
            "telephone_number": "804-732-0685",
            "fax_number": "804-732-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 NORTH UNION STREET",
            "address_2": "SUITE B",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23803",
            "telephone_number": "804-732-0685",
            "fax_number": "804-732-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE ADULT REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-732-0685",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "4943899",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4946634",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.