Organization
PROGRESSIVE INDIVIDUAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELODY BLATTNER (CEO)
(419) 360-6573
Entity
Organization
Contact information
Practice address
5631 ALEXIS RD, SYLVANIA, OH 43560-2355
(419) 360-6573
(419) 824-0809
Mailing address
5631 ALEXIS RD, SYLVANIA, OH 43560-2355
(419) 360-6573
(419) 824-0809
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4809649
—
OH
Enumeration date
06/16/2020
Last updated
06/16/2020
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