Organization
SANA LAKE RECOVERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY L. GLENN LCSW (CHIEF CLINICAL OFFICER)
(314) 392-3822
Entity
Organization
Contact information
Practice address
6300 N LUCEME AVE, KANSAS CITY, MO 64151-3199
(816) 407-9596
Mailing address
6300 N LUCERNE AVE, KANSAS CITY, MO 64151-3199
(816) 407-9596
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
04/05/2022
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