- Enrollment id
- O20180831000000
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1457705360
- Multiple npi flag
- N
- Ccn
- 553171
- Associate id
- 8527318112
- Organization name
- PROGRESS HOME HEALTH CARE INC
- Incorporation date
- 2016-02-26
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 126 S JACKSON ST
- Address line 2
- STE 306
- City
- GLENDALE
- State
- CA
- Zip code
- 912054921