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JESSICA LANE RE LLC NPI 1760197644


NPI Information

NPI: 1760197644
Provider Name: JESSICA LANE RE, LLC

Doing Business As: THE RECOVERY VILLAGE KANSAS CITY

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
11901 JESSICA LN
RAYTOWN, MO
ZIP 64138
Phone: (754) 300-3120
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JESSICA LANE RE, LLC is a substance abuse rehabilitation facility in Raytown, MO. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. JESSICA LANE RE, LLC NPI is 1760197644. The provider is registered as an organization entity type.
The provider Is Doing Business As The Recovery Village Kansas City.

The provider's business location address is:

11901 JESSICA LN
RAYTOWN, MO
ZIP 64138-639
Phone: (754) 300-3120
Fax: (888) 919-4431

The provider's authorized official is Belina Surujon .
The authorized official title is Contracting & Licensing Director and has the following contact phone number (305) 785-5520.

The enumeration date for this NPI number is 1/16/2023 and was last updated on 5/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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