Progression Healthcare Mo, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROGRESSION HEALTHCARE MO, LLC

Practice address

4960 Laclede Ave
Saint Louis, MO 63108-1404

Phone

(314) 361-6240

NPI assigned

Nov 17, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jesseca Wallace

Title

Ceo

Phone

(440) 384-8934

Specialties & licenses 1

Addresses

Tax ID family

Progression Healthcare Mo LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Progression Healthcare Mo, LLC

  • Substance Abuse Rehabilitation Facility
  • Saint Louis, MO
  • NPI 1033712690
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1013510676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 LACLEDE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 LACLEDE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081404",
            "telephone_number": "314-361-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSION HEALTHCARE MO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JESSECA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-384-8934"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.