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General NPI Number Information
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NPI Number | 1639792849
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Entity Type | Organization
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Legal Business Name | THE PROGRESS HOUSE ASSOCIATION
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 4420 E PORTLAND AVE
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City | TACOMA
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State | WA
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Zip | 98404-4666
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Country | US
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Telephone | 253-472-3552
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5373
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City | TACOMA
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State | WA
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Zip | 98415-0373
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Country | US
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Telephone | 404-376-8512
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CYNTHA FEDRICK
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Credential |
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Telephone | 404-376-8512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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