MEDICARE: PROGRESSIVE HEARTS HOME CARE 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
1	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1548996036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE HEARTS HOME CARE INC

Provider Business Mailing Address
First Line	:	1728 ROLLING BROOK DR
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-6465
Country	:	US
Telephone Number	:	214-326-3901
Fax Number	:	214-975-9610

Provider Business Practice Location Address
First Line	:	1728 ROLLING BROOK DR
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-6465
Country	:	US
Telephone Number	:	214-326-3901
Fax Number	:	214-975-9610

Authorized Official
Title or Position	:	ADMIN/PRESIDENT
Name	:	SANDEEP GREWAL
Credential	:
Telephone Number	:	214-326-3901

Provider Enumeration Date	:	07/27/2022
Last Update Date	:	07/27/2022

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