National Provider Identifier Database

PROGRESSIVE ALTERNATIVE LIVING INC
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

PROGRESSIVE ALTERNATIVE LIVING, INC.
410 W BROADWAY ST
HIGGINSVILLE, MO64037-1947
Phone: 660-584-2199
Fax: 660-584-3199
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for PROGRESSIVE ALTERNATIVE LIVING, INC.

NPI Number 1093981052
Legal business name
LBN
PROGRESSIVE ALTERNATIVE LIVING, INC.
Authorized official TERRI MARR - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 04/30/2008
Last updated 07/22/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 8530834180
  • MO Medicaid: 853083400
  • MO Medicaid: 853083418

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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