FERN PARK DEVELOPMENTAL CENTER
NPI 1447259254
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Fern Park, FL

Q: What is Progressive Health Care Providers/Fern Park, LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Active since July 14, 2005CLIA 10D1052571 · Waiver

230 FERN PARK BLVD, FERN PARK, FL 32730(407) 331-7231(407) 331-9251 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Fern Park Developmental Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FERN PARK DEVELOPMENTAL CENTER (NPI 1447259254) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Fern Park, Florida and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through March 28, 2028 and lists Terry Revell, Administrator, as its authorized official.

NPPES Registry Identity

NPI1447259254

Entity TypeOrganization

Primary Taxonomy320600000X

Legal Business NamePROGRESSIVE HEALTH CARE PROVIDERS/FERN PARK, LLC

Location Address230 FERN PARK BLVDFern Park, FL 32730-2500

Mailing Address230 Fern Park BlvdFern Park, FL 32730-2500 · (407) 331-7231 · Fax (407) 331-9251

Phone(407) 331-7231

Fax(407) 331-9251

Organization SubpartNo

Authorized OfficialTerry RevellAdministrator · (407) 331-7231

Enumeration DateJuly 14, 2005

Last NPPES UpdateAugust 22, 2020

✔ NPI 1447259254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320600000X

License✔ Licensed in FL · 4022095

Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

230 FERN PARK BLVD, Fern Park, FL 32730

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Other Names 1

Doing Business AsFern Park Developmental Center

Other Identifiers 1

Other4022095FL · Icf/dd License

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1052571

Fern Park Developmental Center · Fern Park, FL

Active · expires Mar 28, 2028

CLIA Number10D1052571

Laboratory TypeIntermediate Care Facility For Mentally Retarded

Certificate Effective DateMarch 29, 2026

Certificate Expiration DateMarch 28, 2028

Laboratory DirectorJerry L. Poe

Laboratory Phone(407) 331-7231

Laboratory LocationFern Park Developmental Center230 Fern Park Blvd, Fern Park, FL 32730

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Progressive Health Care Providers/Fern Park, LLC's NPI number?

The NPI number for Progressive Health Care Providers/Fern Park, LLC is 1447259254. It was assigned to this organization in the NPPES registry on July 14, 2005. The provider is doing business as Fern Park Developmental Center.

Where is Progressive Health Care Providers/Fern Park, LLC located?

Progressive Health Care Providers/Fern Park, LLC is located at 230 Fern Park Blvd, Fern Park, FL 32730. The listed phone number is (407) 331-7231.

What is Progressive Health Care Providers/Fern Park, LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Does Progressive Health Care Providers/Fern Park, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1052571) is associated with this NPI, valid through March 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Progressive Health Care Providers/Fern Park, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.