Provider Demographics
NPI:1598149254
Name:GARLAND-PROGRESSIVE ELDERCARE SERVICES, INC.
Entity Type:Organization
Organization Name:GARLAND-PROGRESSIVE ELDERCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-262-2571
Mailing Address - Street 1:610 CARPENTER DAM RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8200
Mailing Address - Country:US
Mailing Address - Phone:501-262-2571
Mailing Address - Fax:501-262-2115
Practice Address - Street 1:610 CARPENTER DAM RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8200
Practice Address - Country:US
Practice Address - Phone:501-262-2571
Practice Address - Fax:501-262-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
045235Medicare Oscar/Certification