Organization
PROGRESSION HEALTHCARE MO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSECA WALLACE (CEO)
(440) 384-8934
Entity
Organization
Contact information
Practice address
4960 LACLEDE AVE, SAINT LOUIS, MO 63108-1404
(314) 361-6240
Mailing address
4960 LACLEDE AVE, SAINT LOUIS, MO 63108-1404
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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