| Jessica Lane Re, Llc | |
|
11901 Jessica Ln Raytown MO 64138-2639 | |
| (754) 300-3120 | |
| (888) 919-4431 |
| Full Name | Jessica Lane Re, Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 11901 Jessica Ln, Raytown, Missouri |
| Authorized Official Name and Position | Belina Surujon (CONTRACTING & LICENSING DIRECTOR) |
| Authorized Official Contact | 3057855520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Lane Re, Llc 2200 N Commerce Pkwy Ste 200 Weston FL 33326-3258 Ph: (305) 785-5520 | Jessica Lane Re, Llc 11901 Jessica Ln Raytown MO 64138-2639 Ph: (754) 300-3120 |
| NPI Number | 1760197644 |
|---|---|
| Provider Enumeration Date | 01/16/2023 |
| Last Update Date | 05/11/2026 |
| Certification Date | 05/11/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760197644 | NPI | - | NPPES |
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