Contract Details
Ancillary Care Services
Facility name
Progressive Rehabilitation Agency
Provider ID
P000003867
NPI
1124142799
Tax ID
592390574
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1945 Versailles Street
Sarasota, FL 34239
United States
County
Sarasota
Phone
9413660600 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address