Provider Demographics
NPI:1508006982
Name:PROGRESSIVE HOME HEALTH & HOSPICE LLC
Entity Type:Organization
Organization Name:PROGRESSIVE HOME HEALTH & HOSPICE LLC
Other - Org Name:OMAHA-SELECT HOSPICE & PALLIATIVE CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:GOVERNING BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-469-6739
Mailing Address - Street 1:2301 FM 1187
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3758
Mailing Address - Country:US
Mailing Address - Phone:817-469-6739
Mailing Address - Fax:817-801-3486
Practice Address - Street 1:2550 N DIERS AVE STE K
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1214
Practice Address - Country:US
Practice Address - Phone:308-589-0170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEHHA200907251E00000X
NE251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE287144Medicare PIN
NE281540Medicare PIN