Provider Demographics
NPI:1336146588
Name:PROGRESSIVE HOME HEALTH, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:O
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-263-8300
Mailing Address - Street 1:3712 LAKE WINNIPEG DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5171
Mailing Address - Country:US
Mailing Address - Phone:504-368-4706
Mailing Address - Fax:
Practice Address - Street 1:1141 WHITNEY AVE
Practice Address - Street 2:BUILDING #2
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-5011
Practice Address - Country:US
Practice Address - Phone:504-263-8300
Practice Address - Fax:504-263-8320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA990251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1403407Medicaid
LA1403407Medicaid