Organization
PROGRESSIVE HEALTH CARE PROVIDERS/FERN PARK, LLC
Active
Other names
Fern Park Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY REVELL (ADMINISTRATOR)
(407) 331-7231
Entity
Organization
Contact information
Practice address
230 FERN PARK BLVD, FERN PARK, FL 32730-2500
(407) 331-7231
(407) 331-9251
Mailing address
230 FERN PARK BLVD, FERN PARK, FL 32730-2500
(407) 331-7231
(407) 331-9251
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
4022095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4022095
ICF/DD LICENSE
FL
Enumeration date
07/14/2005
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us