Progressive Community Resources

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PROGRESSIVE COMMUNITY RESOURCES

Practice address

107 W Plover Way
Lavallette, NJ 08735-1237

Phone

(610) 873-4813

Fax

(610) 873-4813

NPI assigned

Apr 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. George Paul Linke Jr., PSYD

Title

Incorporator

Phone

(610) 873-4813

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1821618596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W PLOVER WAY",
            "city": "LAVALLETTE",
            "state": "NJ",
            "postal_code": "087351237",
            "telephone_number": "610-873-4813",
            "fax_number": "610-873-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W PLOVER WAY",
            "city": "LAVALLETTE",
            "state": "NJ",
            "postal_code": "087351237",
            "telephone_number": "610-873-4813",
            "fax_number": "610-873-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE COMMUNITY RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "LINKE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "INCORPORATOR",
        "authorized_official_telephone_number": "610-873-4813",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lavallette, NJ
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

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