LAKESIDE RECOVERY CENTERS INC (NPI# 1134292501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134292501 |
| Entity Type | Organization |
| Organization Name | LAKESIDE RECOVERY CENTERS INC |
| Other Organization Name | LAKESIDE MILAM RECOVERY CENTERS |
| Practice Address |
12845 Ambaum Blvd Sw Seattle WA 98146 |
| Mailing Address |
10322 Ne132nd St Kirkland WA 98034 |
| Practice Telephone | 2062410890 |
| Practice Fax Number | 2062410769 |
| Mailing Telephone | 4258233116 |
| Mailing Fax Number | 4258233132 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CARLTON M KESTER (PRESIDENT) |
| Authorized Official Telephone | 4258233116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
WA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Lakeside Milam Recovery Centers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801950548 | Lakeside Recovery Centers Inc | Clinic/Center | 10322 Ne 132nd St, Kirkland, WA 98034 | 2006-12-20 |
| 1417020355 | Lakeside Recovery Centers Inc | Substance Abuse Rehabilitation Facility | 10322 Ne 132nd St, Kirkland, WA 98034 | 2006-11-16 |
| Street Address |
12845 AMBAUM BLVD SW |
| City | SEATTLE |
| State | WA |
| Zip Code | 98146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063998946 | Vinh T Nguyen | Pharmacist | 10248- 17th Ave Sw, Seattle, WA 98146 | 2018-07-13 |
| 1386032233 | Bowie James Mclean | Counselor | 480 Sw 134th St, Burien, WA 98146 | 2014-12-30 |
| 1518367200 | Joy Hilliker | Counselor | 10803 44th Ave Sw, Seattle, WA 98146 | 2014-08-29 |
| 1841534344 | Phuonglinh Tran | Speech-Language Pathologist | 10811 12th Avenue Southwest, Seattle, WA 98146 | 2012-11-21 |
| 1174867741 | Dorothy Winkler Phelps | Registered Nurse | 2725 Sw116th Street, Burien, WA 98146 | 2012-11-20 |
| 1578829529 | Aaron Thomas Kent | Massage Therapist | 304 Sw 106th St, Seattle, WA 98146 | 2012-04-04 |
| 1154651933 | Robert Anthony Yap | Nurse Practitioner | 12459 Ambaum Blvd S.w., Unit A, Burien, WA 98146 | 2009-12-30 |
| 1952536690 | Renee Dorothea Patterson | Massage Therapist | 11645 23rs Ave Sw, Seattle, WA 98146 | 2009-05-26 |
| 1518125368 | Leeanne Casal | Massage Therapist | 10223 16th Sw, Seattle, WA 98146 | 2008-05-29 |
| 1629299474 | Bryn Annette Karlberg | Massage Therapist | 12263 Shorewood Drive Sw, Seattle, WA 98146 | 2007-05-01 |
| Find all providers in zip 98146 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427266386 | Ryther Child Center | Substance Abuse Rehabilitation Facility | 11729 36th Ave Ne, Seattle, WA 98125 | 2007-05-21 |
| 1548478001 | Ryther Child Center | Substance Abuse Rehabilitation Facility | 2400 Ne 95th St, Seattle, WA 98115-2426 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679765226 | Kitsap County Juvenile Department | Substance Abuse Rehabilitation Facility | 1338 Sw Old Clifton Rd, Port Orchard, WA 98367-9113 | 2007-08-16 |
| 1962921411 | Crystal Jane Andrews | Substance Abuse Rehabilitation Facility | 628 S Cowley St, Spokane, WA 99202-1377 | 2017-09-15 |
| 1184158750 | The Healing Lodge of The Seven Nations | Substance Abuse Rehabilitation Facility | 5600 E 8th Ave, Spokane Valley, WA 99212-0220 | 2017-04-20 |
| 1578008462 | Evergreen Recovery Center | Substance Abuse Rehabilitation Facility | 2601 Summit Ave, Everett, WA 98201-3309 | 2016-12-30 |
| 1992183685 | Felicia Cassandra Reineman | Substance Abuse Rehabilitation Facility | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2015-05-13 |
| 1194118539 | New Developed Nations, LLC | Substance Abuse Rehabilitation Facility | 631 S Richard Allen Ct, Spokane, WA 99202-2345 | 2015-03-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.