PROGRESSIVE BEHAVIOR SYSTEMS, PA (NPI# 1104956390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104956390 |
| Entity Type | Organization |
| Organization Name | PROGRESSIVE BEHAVIOR SYSTEMS, PA |
| Practice Address |
512 6th St Rupert ID 83350-1621 |
| Mailing Address |
Po Box 714 Rupert ID 83350-0714 |
| Practice Telephone | 2084364911 |
| Practice Fax Number | 2084361758 |
| Mailing Telephone | 2084364911 |
| Mailing Fax Number | 2084361758 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-10-03 |
| Authorized Official Name | MR. JERROD K CATMULL (OWNER) |
| Authorized Official Telephone | 2083121911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | 5PBSYSTEM087 | ID | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807353100 | 05 | |
| ID | 806228000 | 05 | |
| ID | 806377200 | 05 | |
| ID | 807307600 | 05 |
| Street Address |
512 6TH ST |
| City | RUPERT |
| State | ID |
| Zip Code | 83350-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225569338 | Tabatha Jo Carson | Social Worker | 512 6th St, Rupert, ID 83350-1621 | 2017-03-22 |
| 1043652365 | Bonita Jo Anne Frazier-shewmaker | Counselor | 512 6th St, Rupert, ID 83350-1621 | 2013-07-28 |
| 1922295997 | Progressive Behavior Systems Pa | Day Training, Developmentally Disabled Services | 512 6th St, Rupert, ID 83350-1621 | 2007-10-03 |
| 1932396900 | Progressive Behavior Systems Pa | Day Training, Developmentally Disabled Services | 512 6th St, Rupert, ID 83350-1621 | 2007-10-03 |
| 1568659530 | Progressive Behavior Systems Pa | Day Training, Developmentally Disabled Services | 512 6th St, Rupert, ID 83350-1621 | 2007-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417349515 | Robbie Joe Carroll | Registered Nurse | 1024 8th Street, Family Health Services, Rupert, ID 83350 | 2015-02-26 |
| 1285921643 | Duane Broderick | Counselor | 2311 Parke Ave., Ste. 8, Burley, ID 83350 | 2011-07-06 |
| 1598798282 | Kerry W Saurey | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| 1093761694 | Family Health Services Corporation | Dental Hygienist | 402 6th St, Rupert, ID 83350 | 2006-05-25 |
| 1376531004 | Jeffrey Scott Swenson | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2005-10-06 |
| 1205312774 | Shawna M Mccaffrey | Nurse Practitioner | 1308 8th St, Rupert, ID 83350 | 2018-07-17 |
| 1386872810 | Brian R Muir | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2009-06-23 |
| 1083816334 | Cameron Mchan | Nurse Practitioner | 1308 8th St Ste 1, Rupert, ID 83350 | 2007-05-31 |
| 1134225956 | Margo Saunders | Specialist | 1308 8th St Ste 1, Rupert, ID 83350 | 2006-09-16 |
| 1619900305 | Don C Pates | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| Find all providers in zip 83350 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497875686 | Family and Children's Therapy Services Pa | Day Training, Developmentally Disabled Services | 906 S Oneida St, Suite #4, Rupert, ID 83350-8200 | 2007-03-30 |
| 1922295997 | Progressive Behavior Systems Pa | Day Training, Developmentally Disabled Services | 512 6th St, Rupert, ID 83350-1621 | 2007-10-03 |
| 1932396900 | Progressive Behavior Systems Pa | Day Training, Developmentally Disabled Services | 512 6th St, Rupert, ID 83350-1621 | 2007-10-03 |
| 1568659530 | Progressive Behavior Systems Pa | Day Training, Developmentally Disabled Services | 512 6th St, Rupert, ID 83350-1621 | 2007-10-03 |
| 1710009410 | Family and Children's Therapy Services, Pa | Day Training, Developmentally Disabled Services | 906 S Oneida St, Suite #4, Rupert, ID 83350-8200 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477086114 | Teton Supported Living LLC | Day Training, Developmentally Disabled Services | 4101 N Creswell Way, Boise, ID 83713-2404 | 2017-04-10 |
| 1962889055 | Community Connections South Central | Day Training, Developmentally Disabled Services | 212 2nd Ave W, #102 & 104, Twin Falls, ID 83301-6016 | 2015-04-28 |
| 1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
| 1902205230 | Andrea Loban | Day Training, Developmentally Disabled Services | 5049 Fox Creek Hollow, Victor, ID 83455-0000 | 2014-08-22 |
| 1336570118 | Independent Living Specialists, LLC | Day Training, Developmentally Disabled Services | 379 Yellowstone Ave, Pocatello, ID 83201-4529 | 2013-12-04 |
| 1871935064 | Community Connections North, Inc. | Day Training, Developmentally Disabled Services | 1230 N Northwood Center Ct, Suite A, Coeur D Alene, ID 83814-4941 | 2013-07-29 |
| 1851734107 | Foundations for Independence LLC | Day Training, Developmentally Disabled Services | 2316 N Cole Rd Ste C, Boise, ID 83704-7365 | 2013-04-16 |
| 1679816912 | A New Hope, LLC | Day Training, Developmentally Disabled Services | 19b Mountain Dr, Pocatello, ID 83204 | 2013-04-05 |
| 1457694176 | A Plus Solutions Center | Day Training, Developmentally Disabled Services | 2311 Park Ave, Unit 3, Suite 12, Burley, ID 83318-2104 | 2013-04-01 |
| 1518208966 | Learning Garden Developmental Preschool | Day Training, Developmentally Disabled Services | 412 E Mullan Ave, Post Falls, ID 83854-7641 | 2013-03-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.