NPIMap

Organization Active NPI

Sana Lake Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Kansas City, MO
National Provider Identifier
1104450337
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SANA LAKE RECOVERY CENTER, LLC
Practice address
6300 N Luceme Ave
Kansas City, MO 64151-3199
Phone
(816) 407-9596
NPI assigned
Feb 26, 2020
Last updated
Apr 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Stacy L. Glenn, LCSWNPI 1689270092
Title
Chief Clinical Officer
Phone
(314) 392-3822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Adult Mental Health Clinic/Center 261QM0850X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

6300 N Luceme Ave
Kansas City, MO 64151-3199

Mailing address

6300 N Lucerne Ave
Kansas City, MO 64151-3199
Phone (816) 407-9596

National Provider Directory

National Provider Directory
Tax ID family
Sana Lake Recovery Center LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6300 N Lucerne Ave
Kansas City, MO 64151
Phone (505) 231-1997

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1104450337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 N LUCERNE AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641513199",
            "telephone_number": "816-407-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N LUCEME AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641513199",
            "telephone_number": "816-407-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANA LAKE RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "314-392-3822",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.