PROGRESSIVE LIVING LLC NPI 1528722790

NPI Information

NPI: 1528722790
Provider Name: PROGRESSIVE LIVING, LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
1314 E GLASS LN
PHOENIX, AZ
ZIP 85042
Phone: (480) 773-8480
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PROGRESSIVE LIVING, LLC is a community based residential treatment facility mental illness in Phoenix, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. PROGRESSIVE LIVING, LLC NPI is 1528722790. The provider is registered as an organization entity type.

The provider's business location address is:

1314 E GLASS LN
PHOENIX, AZ
ZIP 85042-819
Phone: (480) 773-8480
Fax: (480) 546-3626

The provider's authorized official is Lyddia Getaweru .
The authorized official title is Ceo/owner and has the following contact phone number (480) 773-8480.

The enumeration date for this NPI number is 10/25/2021 and was last updated on 10/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility				No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BH0771	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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