PROGRESSIVE PINES, LLC
Skilled Nursing Facility
Wooster, Ohio
Provider NPI: 1710980024
Organization Information:Organization Name: PROGRESSIVE PINES, LLC
Practice Location:
1552 N HONEYTOWN RD WOOSTER, OH 44691 US
Tel: 216-661-6800 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1552 N HONEYTOWN RD WOOSTER, OH 44691 US
Tel: 216-661-6800 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | OH | 6211 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
MEDICAL MUTUAL | 31-1504075.075 | OH | 01 |
ANTHEM | 000000258286 | OH | 01 |
2313893 | OH | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin