Provider Demographics
NPI:1720011836
Name:PROGRESSIVE SKILLED HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PROGRESSIVE SKILLED HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR - DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-702-4466
Mailing Address - Street 1:940 W NOLANA LOOP
Mailing Address - Street 2:SUITE C
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-7406
Mailing Address - Country:US
Mailing Address - Phone:956-702-4466
Mailing Address - Fax:956-702-4477
Practice Address - Street 1:940 W NOLANA LOOP
Practice Address - Street 2:SUITE C
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-7406
Practice Address - Country:US
Practice Address - Phone:956-702-4466
Practice Address - Fax:956-702-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010488251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX743107Medicare Oscar/Certification