Provider Demographics
NPI:1871650655
Name:PROGRESSIVE HOUSING, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE HOUSING, INC.
Other - Org Name:LAKEVIEW LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:KEIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-685-0595
Mailing Address - Street 1:2020 W WAR MEMORIAL DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-6754
Mailing Address - Country:US
Mailing Address - Phone:309-685-0595
Mailing Address - Fax:
Practice Address - Street 1:7270 S SOUTH SHORE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2718
Practice Address - Country:US
Practice Address - Phone:773-721-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0047811315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities