NPIMap

Organization Active NPI

Progress House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Camino, CA
National Provider Identifier
1104961101
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
090002FN Issued in CA
Legal business name
PROGRESS HOUSE, INC.
Practice address
Progress House Perinatal Facility
5494 Pony Express Trail
Camino, CA 95709
Phone
(530) 644-3758
NPI assigned
Feb 20, 2007
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cindy Carlson
Title
Executive Director
Phone
(916) 317-7230

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 090002EN CA
Substance Abuse Rehabilitation Facility 324500000X 090002GN CA
Substance Abuse Rehabilitation Facility 324500000X 090002HN CA
Substance Abuse Rehabilitation Facility 324500000X 090002FN CA Primary
Substance Abuse Rehabilitation Facility 324500000X 090002IN CA

Addresses

Primary practice location

Progress House Perinatal Facility
5494 Pony Express Trail
Camino, CA 95709

Mailing address

PO Box 1666
Placerville, CA 95667-1666

Other identifiers 2

IdentifierTypeStateIssuer
090913OtherCADRUG MEDI-CAL
090918OtherCADRUG MEDI-CAL

National Provider Directory

National Provider Directory
Tax ID family
Progress House Inc Detox Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1104961101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1666",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956671666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PROGRESS HOUSE PERINATAL FACILITY",
            "address_2": "5494 PONY EXPRESS TRAIL",
            "city": "CAMINO",
            "state": "CA",
            "postal_code": "95709",
            "telephone_number": "530-644-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESS HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "916-317-7230"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "090002EN",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "090002GN",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "090002HN",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "090002FN",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "090002IN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "090913",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "090918",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.