Organization
PROGRESSIVE ALTERNATIVE LIVING, INC.
Active
Other names
PAL
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI A. MARR (DIRECTOR)
(660) 584-2199
Entity
Organization
Contact information
Practice address
410 W BROADWAY ST, HIGGINSVILLE, MO 64037-1947
(660) 584-2199
(660) 584-3199
Mailing address
410 W BROADWAY ST, HIGGINSVILLE, MO 64037-1947
(660) 584-2199
(660) 584-3199
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
8530834180
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
853083400
—
MO
05
—
853083418
—
MO
Enumeration date
04/30/2008
Last updated
07/22/2008
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