| Jessica Lane Re, Llc | |
|
305 Nw Englewood Ct Ste 300 Gladstone MO 64118-4000 | |
| (754) 300-3120 | |
| (888) 919-4431 |
| Full Name | Jessica Lane Re, Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 305 Nw Englewood Ct Ste 300, Gladstone, Missouri |
| Authorized Official Name and Position | Belina Surujon (VP CONTRACTING & LICENSING) |
| Authorized Official Contact | 3057855520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Lane Re, Llc 100 Se 3rd Ave Ste 1800 Fort Lauderdale FL 33394-0011 Ph: (754) 300-3120 | Jessica Lane Re, Llc 305 Nw Englewood Ct Ste 300 Gladstone MO 64118-4000 Ph: (754) 300-3120 |
| NPI Number | 1023820073 |
|---|---|
| Provider Enumeration Date | 01/24/2025 |
| Last Update Date | 01/24/2025 |
| Certification Date | 01/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023820073 | NPI | - | NPPES |
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