Provider Demographics
NPI:1124797717
Name:PROGRESSIVE HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:PROGRESSIVE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUFUNMILOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNMODEDE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:720-339-2129
Mailing Address - Street 1:6000 E EVANS AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5406
Mailing Address - Country:US
Mailing Address - Phone:720-252-4325
Mailing Address - Fax:888-863-3084
Practice Address - Street 1:6000 E. EVANS AVENUE
Practice Address - Street 2:BLDG. 1 SUITE 401
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5406
Practice Address - Country:US
Practice Address - Phone:720-252-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care