Whalio Doctors

NPI 1760197644

Jessica Lane Re, LLC

Organisation Substance Abuse Rehabilitation Facility Raytown, MO

Practice location

Address
11901 Jessica Ln, Raytown, MO 64138-2639
Phone
(754) 300-3120
Fax
(888) 919-4431
Mailing address
2200 N Commerce Pkwy STE 200, Weston, FL 33326-3258

Authorised official

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

Registered specialties (3)

Substance Abuse Rehabilitation Facility Primary
Residential Treatment Facilities Taxonomy 324500000X
Mental Health Clinic/Center (Including Community Mental Health Center)
Ambulatory Health Care Facilities Taxonomy 261QM0801X
Psychiatric Residential Treatment Facility
Residential Treatment Facilities Taxonomy 323P00000X

Registry record

NPI
1760197644
Entity type
Organization
NPI issued
16 Jan 2023
Record last updated
11 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.