SANA LAKE RECOVERY CENTER, LLC
NPI 1902430135
Substance Abuse Rehabilitation Facility in Kansas City, MO

Q: What is Sana Lake Recovery Center, LLC's NPI number?

The NPI number for Sana Lake Recovery Center, LLC is 1902430135. It was assigned to this organization in the NPPES registry on February 26, 2020.

Q: What is Sana Lake Recovery Center, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Active since February 26, 2020CLIA 26D2218818 · Waiver

800 E 101ST TER STE 350, KANSAS CITY, MO 64131(816) 222-4347(816) 407-9597 Get Directions Write a Review

NPPES record last updated: March 31, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 31, 2020, Feb 26, 2020 (2 updates tracked since 2020).

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About Sana Lake Recovery Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANA LAKE RECOVERY CENTER, LLC (NPI 1902430135) is a healthcare organization registered as a substance abuse rehabilitation facility in Kansas City, Missouri and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through March 30, 2027 and lists Stacy Glenn, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1902430135

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NameSANA LAKE RECOVERY CENTER, LLC

Location Address800 E 101ST TER STE 350Kansas City, MO 64131-5310

Mailing Address8350 Highway 30Dittmer, MO 63023-1909 · (636) 944-4436

Phone(816) 222-4347

Fax(816) 407-9597

Organization SubpartNo

Authorized OfficialStacy GlennClinical Director · (314) 392-3822

Enumeration DateFebruary 26, 2020

Last NPPES UpdateMarch 31, 20202 updates tracked since enumeration

NPPES CertifiedMarch 31, 2020

✔ NPI 1902430135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

Definition

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.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X

800 E 101ST TER STE 350, Kansas City, MO 64131

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2218818

Sana Lake Recovery Center, LLC · Dittmer, MO

Active · expires Mar 30, 2027

CLIA Number26D2218818

Laboratory TypeInpatient Mmi Detox Sud T

Certificate Effective DateMarch 31, 2025

Certificate Expiration DateMarch 30, 2027

Laboratory DirectorJeremy Woods

Laboratory Phone(816) 222-4347

Laboratory LocationSana Lake Recovery Center, LLC100 Sana Lake Recovery Way, Dittmer, MO 63023

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA LENAE JACKSON

Massage Therapist