Provider Demographics
NPI:1154872158
Name:PROGRESSIVE HOME HEALTH AND HOSPICE CARE, LLC
Entity type:Organization
Organization Name:PROGRESSIVE HOME HEALTH AND HOSPICE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-248-7851
Mailing Address - Street 1:1619 H STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-1209
Mailing Address - Country:US
Mailing Address - Phone:500-600-3009
Mailing Address - Fax:209-422-3776
Practice Address - Street 1:24301 SOUTHLAND DR
Practice Address - Street 2:SUITE B8
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1542
Practice Address - Country:US
Practice Address - Phone:510-600-3009
Practice Address - Fax:209-422-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based