Organization
PROGRESS HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY CARLSON (EXECUTIVE DIRECTOR)
(916) 317-7230
Entity
Organization
Contact information
Practice address
PROGRESS HOUSE PERINATAL FACILITY, 5494 PONY EXPRESS TRAIL, CAMINO, CA 95709
(530) 644-3758
Mailing address
PO BOX 1666, PLACERVILLE, CA 95667-1666
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
090002EN
CA
324500000X
Substance Abuse Rehabilitation Facility
Primary
090002FN
CA
324500000X
Substance Abuse Rehabilitation Facility
090002GN
CA
324500000X
Substance Abuse Rehabilitation Facility
090002HN
CA
324500000X
Substance Abuse Rehabilitation Facility
090002IN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090913
DRUG MEDI-CAL
CA
01
—
090918
DRUG MEDI-CAL
CA
Enumeration date
02/20/2007
Last updated
09/23/2021
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