Progressive Wellness Center LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

PROGRESSIVE WELLNESS CENTER LLC

Practice address

860 Blue Gentian Rd Ste 200
Saint Paul, MN 55121-1567

Phone

(612) 261-7454

NPI assigned

Dec 3, 2024

Organization subpart

No

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

Authorized official

Name

Zakaria Muhumed

Title

Owner

Phone

(612) 261-7454

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1760208995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BLUE GENTIAN RD STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551211567",
            "telephone_number": "612-261-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 BLUE GENTIAN RD STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551211567",
            "telephone_number": "612-261-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "MUHUMED",
        "authorized_official_first_name": "ZAKARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-261-7454"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.