Progressive Lifestyles Home Healthcare, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROGRESSIVE LIFESTYLES HOME HEALTHCARE, LLC

Practice address

40 RG Starley Rd
MC Intyre, GA 31054-2259

Phone

(478) 946-0036

NPI assigned

Feb 23, 2016

Organization subpart

No

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

Authorized official

Name

Samantha Walker

Title

Ceo/Owner

Phone

(478) 233-4611

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1548629231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "city": "IRWINTON",
            "state": "GA",
            "postal_code": "310420163",
            "telephone_number": "478-946-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 RG STARLEY RD",
            "city": "MC INTYRE",
            "state": "GA",
            "postal_code": "310542259",
            "telephone_number": "478-946-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE LIFESTYLES HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "478-233-4611"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Byram, LCSW
• Monica Octavia Daniels-Drayton, NP
• Heartland EMS, Inc.
• Crystal Jackson, LPN
• PRN Nursing Solutions, LLC

• In Home Supportive Care Agency in MC Intyre, GA
• Providers in MC Intyre, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.