Healthcare Provider Details

I. General information

NPI: 1093640930
Provider Name (Legal Business Name): MUSE RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5940 LAMAR AVE
MISSION KS
66202-3231
US

IV. Provider business mailing address

9712 HOLLY ST
KANSAS CITY MO
64114-3841
US

V. Phone/Fax

Practice location:
  • Phone: 804-682-1083
  • Fax:
Mailing address:
  • Phone: 804-682-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRENDA FLETCHER
Title or Position: DIRECTOR/CFP
Credential:
Phone: 804-682-1083