Organization
PROGRESSIVE PINES, LLC
Active
Other names
Glendora Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISAAK MARKOVITS (DIRECTOR OF FINANCE)
(608) 448-6200
Entity
Organization
Contact information
Practice address
1552 N HONEYTOWN RD, WOOSTER, OH 44691-9511
(216) 661-6800
(216) 739-3789
Mailing address
1632 61ST ST, BROOKLYN, NY 11204-2109
(608) 448-6200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
6211
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000258286
ANTHEM
OH
05
—
2313893
—
OH
01
—
31-1504075.075
MEDICAL MUTUAL
OH
Enumeration date
05/31/2005
Last updated
01/14/2025
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