SANA LAKE RECOVERY CENTER, LLC (NPI# 1902462278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902462278 |
| Entity Type | Organization |
| Organization Name | SANA LAKE RECOVERY CENTER, LLC |
| Practice Address |
8350 State Route 30 Dittmer MO 63023 |
| Practice Telephone | 3143923822 |
| Mailing Telephone | 3143923822 |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-06-27 |
| Authorized Official Name | MS. STACY L. GLENN (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 3143923822 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417577107 | Sana Lake Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 150 Sana Lake Recovery Way, Dittmer, MO 63023 | 2020-04-22 |
| 1861026098 | Sana Lake Recovery Center, LLC | Community/Behavioral Health | 140 Weldon Parkway, Maryland Heights, MO 63043 | 2020-02-26 |
| 1902430135 | Sana Lake Recovery Center, LLC | Community/Behavioral Health | 800 E 101st Ter Ste 350, Kansas City, MO 64131-5310 | 2020-02-26 |
| 1104450337 | Sana Lake Recovery Center, LLC | Community/Behavioral Health | 1512 Ne 96th St Ste A, Liberty, MO 64068-7174 | 2020-02-26 |
| Street Address |
8350 STATE ROUTE 30 |
| City | DITTMER |
| State | MO |
| Zip Code | 63023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740689181 | David Sherman | Otolaryngology | 8350 State Route 30, Dittmer, MO 63023-1909 | 2014-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417577107 | Sana Lake Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 150 Sana Lake Recovery Way, Dittmer, MO 63023 | 2020-04-22 |
| 1588007256 | Blake Wells | Speech-Language Pathologist | 7887 Ditter Ridge Road, Dittmer, MO 63023 | 2013-04-12 |
| 1396999140 | Valerie Puett | Speech-Language Pathologist | 7887 Dittmer Ridge Rd, Dittmer, MO 63023-1113 | 2008-11-06 |
| 1447680590 | Rose Aiazzi | Speech-Language Pathologist | 7887 Dittmer Ridge Rd, Dittmer, MO 63023-1113 | 2013-11-26 |
| 1952736027 | Leann Christine Carruthers | Speech-Language Pathologist | 7887 Dittmer Ridge Rd, Dittmer, MO 63023-1113 | 2013-09-09 |
| 1215190558 | Cynthia Xakellis Wiederholt | Emergency Medicine | Fast Track Urgent Care, 2686 N Highway 67, Florissant, MO 63023-1438 | 2008-07-07 |
| 1184832552 | Karen Kramer | Counselor | 9009 Morse Mill Rd, Dittmer, MO 63023-2046 | 2007-05-18 |
| 1053786350 | Danielle Boswell | Respiratory Therapist, Registered | 9810 Morse Mill Rd, Dittmer, MO 63023-2709 | 2015-12-11 |
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417577107 | Sana Lake Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 150 Sana Lake Recovery Way, Dittmer, MO 63023 | 2020-04-22 |
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|---|---|---|---|---|
| 1073112967 | Hurdler Outreach Services LLC | Substance Abuse Rehabilitation Facility | 6425 Evanston Ave, Raytown, MO 64133-4931 | 2020-10-21 |
| 1912529041 | Ip Reserve | Substance Abuse Rehabilitation Facility | 21708 Nickel Ave, Gallatin, MO 64640-6369 | 2020-05-12 |
| 1639723463 | Haven Recovery Homes | Substance Abuse Rehabilitation Facility | 3929 Michigan Ave, Saint Louis, MO 63118-4324 | 2019-07-30 |
| 1356875678 | Summit Bhc Saint Louis, LLC | Substance Abuse Rehabilitation Facility | 22933 Hwy 61, Eolia, MO 63344 | 2017-04-13 |
| 1821549122 | Preferred Family Healthcare, Inc | Substance Abuse Rehabilitation Facility | 2415 W Catalpa St, Springfield, MO 65807-1123 | 2016-10-21 |
| 1225496052 | Betty Lou Wallace Recovery LLC | Substance Abuse Rehabilitation Facility | 13350 Holmes Rd, Kansas City, MO 64145-1437 | 2016-02-08 |
| 1326414350 | Synergy Recovery Center | Substance Abuse Rehabilitation Facility | 3955 S Farm Road 223, Rogersville, MO 65742-8807 | 2015-08-13 |
| 1821406174 | Preferred Family Healthcare, Inc | Substance Abuse Rehabilitation Facility | 4066 Dunnica, Saint Louis, MO 63118 | 2014-07-31 |
| 1932517653 | Summit Bhc Lafayette LLC | Substance Abuse Rehabilitation Facility | 551 Warren Ave, Saint Louis, MO 63130-4155 | 2014-07-25 |
| 1538571542 | Mothers Against Methamphetamine-opening Doors To Recovery | Substance Abuse Rehabilitation Facility | 17404 Freedom Rd, Willow Springs, MO 65793-7932 | 2014-05-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.