NPIMap

Organization Active NPI

Sana Lake Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Dittmer, MO
National Provider Identifier
1417577107
Registry record updated May 20, 2025
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
150 Sana Lake Recovery Way
Dittmer, MO 63023
Phone
(636) 944-4400
Fax
(636) 285-9574
NPI assigned
Apr 22, 2020
Last updated
May 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Ashley Murry, LCSW
Title
Chief Clinical Officer
Phone
(314) 806-1026

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

150 Sana Lake Recovery Way
Dittmer, MO 63023

Mailing address

8350 State Route 30
Dittmer, MO 63023
Phone (314) 392-3822

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2168868Sana Lake Recovery Center, LLC150 Sana Lake Recovery Way, Dittmer, MO 63023Certificate of waiverJul 9, 2027

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

150 Sana Lake Recovery Way
Dittmer, MO 63023
Phone (636) 944-4400

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": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1417577107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 STATE ROUTE 30",
            "city": "DITTMER",
            "state": "MO",
            "postal_code": "63023",
            "telephone_number": "314-392-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SANA LAKE RECOVERY WAY",
            "city": "DITTMER",
            "state": "MO",
            "postal_code": "63023",
            "telephone_number": "636-944-4400",
            "fax_number": "636-285-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANA LAKE RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "MURRY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "314-806-1026",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dittmer, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.