NPIMap

Organization Active NPI

Progress Valley, Inc.

  • Substance Abuse Rehabilitation Facility
  • Bloomington, MN
National Provider Identifier
1194852590
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
801980-1-CDT Issued in MN
Legal business name
PROGRESS VALLEY, INC.
Practice address
1100 E 80TH St
Bloomington, MN 55420-1426
Phone
(952) 956-3100
Fax
(612) 869-3225
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Authorized official

Name
Dr. Jared Bostrom, DMFT, LMFT, LADC
Title
Chief Executive Officer
Phone
(952) 956-3101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 801980-1-CDT MN Primary

Addresses

Primary practice location

1100 E 80TH St
Bloomington, MN 55420-1426

Mailing address

1100 E 80TH St
Bloomington, MN 55420-1426
Phone (952) 956-3100

Other identifiers 1

IdentifierTypeStateIssuer
876255400OtherMNMHCP PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Progress Valley Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

308 E 78th St
Richfield, MN 55423
Phone (612) 827-2517

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777939200000",
    "number": "1194852590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E 80TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201426",
            "telephone_number": "952-956-3100",
            "fax_number": "612-869-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E 80TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201426",
            "telephone_number": "952-956-3100",
            "fax_number": "612-869-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESS VALLEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A",
        "authorized_official_last_name": "BOSTROM",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "952-956-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMFT, LMFT, LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "801980-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP PROVIDER NUMBER",
            "identifier": "876255400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.