MEDICARE: PEOPLE IN PROGRESS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	190043EN	CA

General Provider Information

NPI Number	:	1427357086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEOPLE IN PROGRESS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 17216
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-0216
Country	:	US
Telephone Number	:	213-384-6689
Fax Number	:	213-384-7279

Provider Business Practice Location Address
First Line	:	2010 WILSHIRE BLVD STE 1010
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3592
Country	:	US
Telephone Number	:	213-413-9122
Fax Number	:	213-413-9132

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JOSHUA B SMITH
Credential	:
Telephone Number	:	213-384-6689

Provider Enumeration Date	:	03/22/2011
Last Update Date	:	04/26/2012

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