- Enrollment id
- O20220808000626
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1447861141
- Multiple npi flag
- N
- Ccn
- 757504
- Associate id
- 1557743598
- Organization name
- PROGRESS HEALTH CARE INC
- Incorporation date
- 2020-07-30
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 204
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199