NPIMap

Organization Active NPI

Progressive Life

  • Mental Illness Intermediate Care Facility
  • Lewisville, TX
National Provider Identifier
1487610077
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
License
006716 Issued in TX
Legal business name
PROGRESSIVE LIFE
Practice address
1680 S Edmonds LN
Lewisville, TX 75067-5803
Phone
(972) 436-4538
NPI assigned
Apr 24, 2006
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
Mr. Mike Hawker
Title
Cfo
Phone
(210) 340-7155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X 006716 TX Primary

Addresses

Primary practice location

1680 S Edmonds LN
Lewisville, TX 75067-5803

Mailing address

845 Proton Rd
San Antonio, TX 78258-4203
Phone (210) 340-7155

Other names 1

  • Progressive Life of North Texas Other name

National Provider Directory

National Provider Directory
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.

Locations

1680 S Edmonds Ln
Lewisville, TX 75067
Phone (972) 436-4538

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487610077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 PROTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584203",
            "telephone_number": "210-340-7155",
            "fax_number": "210-308-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 S EDMONDS LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750675803",
            "telephone_number": "972-436-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAWKER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "210-340-7155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "TX",
            "license": "006716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Life of North Texas",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.