Organization
SANA LAKE RECOVERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY GLENN LCSW (CLINICAL DIRECTOR)
(314) 392-3822
Entity
Organization
Contact information
Practice address
800 E 101ST TER STE 350, KANSAS CITY, MO 64131-5310
(816) 222-4347
(816) 407-9597
Mailing address
8350 HIGHWAY 30, DITTMER, MO 63023-1909
(636) 944-4436
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
03/31/2020
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