Provider Demographics
NPI:1679961031
Name:PROGRESS IN MOTION, INC
Entity Type:Organization
Organization Name:PROGRESS IN MOTION, INC
Other - Org Name:PROGRESS IN MOTION TREATMENT CTR
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-297-3546
Mailing Address - Street 1:8035 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-1932
Mailing Address - Country:US
Mailing Address - Phone:818-297-3546
Mailing Address - Fax:818-280-6650
Practice Address - Street 1:8035 OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-1932
Practice Address - Country:US
Practice Address - Phone:818-297-3546
Practice Address - Fax:818-280-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190802AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility