26D2294582 CLIA NUMBER - SUMMIT BHC SAINT LOUIS, LLC DBA THE AVIARY RECOVERY CENTER

Laboratory Demographics

CLIA Number: 26D2294582

Facility Name: SUMMIT BHC SAINT LOUIS, LLC DBA THE AVIARY RECOVERY CENTER

Facility Address:
3340 NE RALPH POWER ROAD
LEES SUMMIT, MO
ZIP 64064
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Facility Phone Number: 817 944-9419

Facility Type: Other - OUTPATIENT CLINIC

Certificate Type: Waiver

NPI Number: 1336508845

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
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.

CLIA Record

Field Name	Field Value
CLIA Number	26D2294582
LAB Type	Other - OUTPATIENT CLINIC
Facility Name	SUMMIT BHC SAINT LOUIS, LLC DBA THE AVIARY RECOVERY CENTER
Street	3340 NE RALPH POWER ROAD
City	LEES SUMMIT
State	MO
ZIP	64064
Phone	817 944-9419
CertificateType	4
CertificateEffectiveDate	11/28/2023
CertificateExpirationDate	11/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024