Progressive Residential Services of New Mexico, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

PROGRESSIVE RESIDENTIAL SERVICES OF NEW MEXICO, INC.

Practice address

250 S Main St
Suite a
Las Cruces, NM 88001-1278

Phone

(575) 523-8431

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

Rachel Guilford

Title

Coo

Phone

(248) 641-7200

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• P.R.S. of New Mexico Other name

Locations

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1801942529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 N ADAMS RD",
            "address_2": "SUITE 165",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041566",
            "telephone_number": "248-641-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S MAIN ST",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011278",
            "telephone_number": "575-523-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE RESIDENTIAL SERVICES OF NEW MEXICO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "GUILFORD",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "248-641-7200"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D4244",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P.R.S. of New Mexico",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Jerry G Prochazka, LMHC, CRC
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• David Protextor
• Devonna Protextor
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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.