NPIMap

Organization Active NPI

Progressive Habilitative Services, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Laurel, MD
National Provider Identifier
1679791073
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
PROGRESSIVE HABILITATIVE SERVICES, INC.
Practice address
13629 Baltimore Ave
Laurel, MD 20707-5095
Phone
(301) 317-9996
Fax
(301) 317-9988
NPI assigned
Apr 23, 2007
Last updated
Apr 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Authorized official

Name
Mrs. Maude Marie Koker
Title
President Ceo
Phone
(301) 317-9996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

13629 Baltimore Ave
Laurel, MD 20707-5095

Mailing address

545 8TH St SE
Washington, DC 20003-2897
Phone (202) 544-9057

Other identifiers 1

IdentifierTypeStateIssuer
035555200MedicaidDC

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

545 8th St SE
Washington, DC 20003

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1679791073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 8TH ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032897",
            "telephone_number": "202-544-9057",
            "fax_number": "202-544-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE HABILITATIVE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "KOKER",
        "authorized_official_first_name": "MAUDE MARIE",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "301-317-9996",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035555200",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.