NPIMap

Organization Active NPI

Sana Lake Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Overland Park, KS
National Provider Identifier
1477147478
Registry record updated Feb 22, 2021
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
10881 Lowell Ave
Overland Park, KS 66210-1653
Phone
(314) 392-3822
NPI assigned
Feb 22, 2021
Last updated
Feb 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Authorized official

Name
Stacy 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

10881 Lowell Ave
Overland Park, KS 66210-1653

Mailing address

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

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

10881 Lowell Ave
Overland Park, KS 66210
Phone (314) 392-3822

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": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1477147478",
    "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": "10881 LOWELL AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101653",
            "telephone_number": "314-392-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANA LAKE RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "314-392-3822",
        "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 Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.