Jessica Lane Re, LLC
NPI #1760197644 in Raytown, Missouri
Provider Information
- NPI Number
- 1760197644
- Entity Type
- Organization
- Organization Name
- Jessica Lane Re, LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Jan 16, 2023
- Last Updated
- Aug 14, 2025
Practice Location
Authorized Official
- Name
- BELINA SURUJON
- Title
- CONTRACTING & LICENSING DIRECTOR
- Phone
- (305) 785-5520
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
| Psychiatric Residential Treatment Facility |
| Substance Abuse Rehabilitation Facility |
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