Organization · Type 2 NPI

Jessica Lane Re, LLC

Substance Abuse Rehabilitation Facility · Raytown, MO

NPI number 1760197644 Active

Practice location

11901 Jessica Ln
Raytown, MO 64138-2639

Call (754) 300-3120 Map

Fax (888) 919-4431

Mailing address

2200 N Commerce Pkwy Ste 200
Weston, FL 33326-3258

Other practice locations

305 NW Englewood Ct Ste 300, Gladstone, MO 64118-4000 · (305) 785-5520

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Psychiatric Residential Treatment Facility	323P00000X	None listed
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

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.

10 other providers at this address

Other substance abuse rehabilitation facility providers in Raytown

Hurdler Outreach Services LLCSubstance Abuse Rehabilitation Facility Raytown, MO NPI 1073112967

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NPI record

NPI: 1760197644
Entity type: Organization (Type 2)
Issued: Jan 16, 2023
Last updated: May 11, 2026
Status: Active

Other names

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The Recovery Village Kansas City · doing business as
The Recovery Village Kansas City · doing business as

Authorized official

Belina Surujon
Contracting & Licensing Director
(305) 785-5520

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1760197644

Jessica Lane Re, LLC's National Provider Identifier is 1760197644, issued on Jan 16, 2023. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Raytown, MO. The record was last updated on May 11, 2026.