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Jessica Lane Re, LLC — NPI 1760197644, Raytown, MO | NPI Central

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NPI 1760197644

OrganizationActive

Jessica Lane Re, LLC

NPI 1760197644 · Substance Abuse Rehabilitation Facility · Raytown, MO

Provider details

NPI number: 1760197644
Entity type: Organization
Primary specialty: Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
Organization subpart: No
Authorized official: Belina Surujon, Contracting & Licensing Director(305) 785-5520

Specialties & taxonomies

Substance Abuse Rehabilitation FacilityPrimary324500000X
Residential Treatment Facilities
Psychiatric Residential Treatment Facility323P00000X
Residential Treatment Facilities
Mental Health Clinic/Center (Including Community Mental Health Center)261QM0801X
Ambulatory Health Care Facilities

Practice location

11901 Jessica Ln

Raytown, MO 64138-2639

Phone: (754) 300-3120

Fax: (888) 919-4431

Approximate (ZIP-level) locationGet directions

More MO providers

Mailing address

2200 N Commerce Pkwy Ste 200

Weston, FL 33326-3258

Other names (DBA / former)

Doing business as: The Recovery Village Kansas City
Doing business as: The Recovery Village Kansas City

Additional practice locations (1)

305 Nw Englewood Ct Ste 300
Gladstone, MO 64118-4000
Phone: (305) 785-5520
Fax: (888) 919-4431

Registry dates

Enumerated: 2023-01-16
Last updated: 2026-05-11
Certified: 2026-05-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.