Progressive Life, LTD

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

PROGRESSIVE LIFE, LTD

Practice address

17016 Copperhead Dr
Round Rock, TX 78664-8616

Phone

(512) 892-2191

NPI assigned

Sep 10, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Gary Bowers

Title

President

Phone

(210) 340-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Progressive Life of Central Texas Doing business as

Tax ID family

Progessive Life3 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.

• Progessive Life

  • Mental Illness Intermediate Care Facility
  • San Antonio, TX
  • NPI 1366408312
  NPD tax ID
• Progressive Life

  • Mental Illness Intermediate Care Facility
  • Lewisville, TX
  • NPI 1487610077
  NPD tax ID

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1477860435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2579 WESTERN TRAILS BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451578",
            "telephone_number": "512-892-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17016 COPPERHEAD DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786648616",
            "telephone_number": "512-892-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE LIFE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-340-7155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001008861",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Life of Central Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joel Prochet Sr.
• Kiersten Light Prochnow, LPC
• Carrie Ann Proctor, LPC
• Professional Massage Associates PLLC
• Profound Hospice Care, LLC
• Donna Marie Prokop-Fettig, P.A.-C
• Courtney Pruitt
• Alexis Claris Pruneda, LPC-A
• Madison Ashley Pryor, PA-C
• Psychological Solutions, PLLC

• Intellectual Disabilities Intermediate Care Facility in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Intellectual Disabilities Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.