NPIMap

Organization Active NPI

Progressive Habilitative Services, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Washington, DC
National Provider Identifier
1164735817
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
PROGRESSIVE HABILITATIVE SERVICES, INC
Practice address
6405 Chillum PL NW
Washington, DC 20012-2133
Phone
(202) 545-0393
Fax
(202) 545-0392
NPI assigned
Jul 23, 2010
Last updated
Sep 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Ramesh Gundu
Title
Accounts Manager
Phone
(301) 317-9996

Specialties & licenses 1

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

Addresses

Primary practice location

6405 Chillum PL NW
Washington, DC 20012-2133

Mailing address

13629 Baltimore Ave
Laurel, MD 20707-5095
Phone (301) 317-9996

Other identifiers 1

IdentifierTypeStateIssuer
037910700MedicaidDC

National Provider Directory

National Provider Directory
Tax ID family
Progressive Habilitative Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

6405 Chillum Pl NW
Washington, DC 20012
Phone (202) 291-3672

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1164735817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13629 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075095",
            "telephone_number": "301-317-9996",
            "fax_number": "301-317-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 CHILLUM PL NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200122133",
            "telephone_number": "202-545-0393",
            "fax_number": "202-545-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE HABILITATIVE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "GUNDU",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "301-317-9996"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037910700",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.