Organization
PROGRESS VALLEY, INC.
Active
Organization
PROGRESS VALLEY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED BOSTROM DMFT, LMFT, LADC (CHIEF EXECUTIVE OFFICER)
(952) 956-3101
Entity
Organization
Contact information
Practice address
2675 LONG LAKE RD STE 125, ROSEVILLE, MN 55113-2823
(952) 956-3100
Mailing address
1100 E 80TH ST, BLOOMINGTON, MN 55420-1426
(952) 956-3100
(612) 869-3225
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/22/2024
Last updated
05/06/2026
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