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NPI Code Detail

MEDICARE: THE PROGRESSIVE HEALTH CARE GROUP, INC.

MEDICARE: THE PROGRESSIVE HEALTH CARE GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320700000XPhysical Disabilities Residential Treatment Facility031268MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116237161OTHERMOSTATE ID

General Provider Information

NPI Number : 1063408011
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE PROGRESSIVE HEALTH CARE GROUP, INC.
Provider Business Mailing Address
First Line : PO BOX 277
Second Line :
City : SAVANNAH
State : MO
Zip : 64485-0277
Country : US
Telephone Number : 816-324-5991
Fax Number : 816-324-3556
Provider Business Practice Location Address
First Line : 13277 STATE ROUTE D
Second Line :
City : SAVANNAH
State : MO
Zip : 64485-9431
Country : US
Telephone Number : 816-324-5991
Fax Number : 816-324-3556
Authorized Official
Title or Position : COO/CFO
Name : MR. THOMAS HUDSPETH
Credential :
Telephone Number : 573-392-0316
Provider Enumeration Date : 09/26/2005
Last Update Date : 08/22/2020

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Directions to “THE PROGRESSIVE HEALTH CARE GROUP, INC. ” Practice Location

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