Healthcare Provider Details

I. General information

NPI: 1346304326
Provider Name (Legal Business Name): PROGRESS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 11/13/2022
Certification Date: 11/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 CORTLAND AVE
SAN FRANCISCO CA
94110-5435
US

IV. Provider business mailing address

368 FELL ST
SAN FRANCISCO CA
94102-5144
US

V. Phone/Fax

Practice location:
  • Phone: 415-550-1881
  • Fax: 415-550-1791
Mailing address:
  • Phone: 415-861-0828
  • Fax: 415-861-0257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number380503835
License Number StateCA

VIII. Authorized Official

Name: STEVEN FIELDS
Title or Position: EXECUTIVE DIRECTOR
Credential: MA
Phone: 415-861-0828