Organization
PROGRESSIVE LIFE
Active
Other names
Progressive Life of North Texas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE HAWKER (CFO)
(210) 340-7155
Entity
Organization
Contact information
Practice address
1680 S EDMONDS LN, LEWISVILLE, TX 75067-5803
(972) 436-4538
Mailing address
845 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 340-7155
(210) 308-9780
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
006716
TX
Other
Enumeration date
04/24/2006
Last updated
08/22/2020
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