Provider Demographics
NPI:1619137999
Name:PROGRESSIVE ALTERNATIVES, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE ALTERNATIVES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CEO
Authorized Official - Phone:269-679-2738
Mailing Address - Street 1:PO BOX 20054
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49019-1054
Mailing Address - Country:US
Mailing Address - Phone:269-679-2738
Mailing Address - Fax:269-679-2738
Practice Address - Street 1:10476 W U AVE
Practice Address - Street 2:
Practice Address - City:SCHOOLCRAFT
Practice Address - State:MI
Practice Address - Zip Code:49087-8475
Practice Address - Country:US
Practice Address - Phone:269-679-2273
Practice Address - Fax:269-679-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS390016162311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home