Organization
SANA LAKE RECOVERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY GLENN LCSW (CHIEF CLINICAL OFFICER)
(314) 392-3822
Entity
Organization
Contact information
Practice address
10881 LOWELL AVE, OVERLAND PARK, KS 66210-1653
(314) 392-3822
Mailing address
8350 STATE ROUTE 30, DITTMER, MO 63023
(314) 392-3822
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
02/22/2021
Last updated
02/22/2021
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