Provider Demographics
NPI:1376794941
Name:PROGRESSIVE HEALTH CENTER
Entity Type:Organization
Organization Name:PROGRESSIVE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-788-9399
Mailing Address - Street 1:701 E HAMPDEN AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2737
Mailing Address - Country:US
Mailing Address - Phone:303-788-9399
Mailing Address - Fax:303-788-1352
Practice Address - Street 1:701 E HAMPDEN AVE STE 225
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2737
Practice Address - Country:US
Practice Address - Phone:303-788-9399
Practice Address - Fax:303-788-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service