LAKESIDE FOR CHILDREN (NPI# 1750618419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750618419 |
| Entity Type | Organization |
| Organization Name | LAKESIDE FOR CHILDREN |
| Other Organization Name | LAKESIDE ACADEMY |
| Practice Address |
3921 Oakland Dr Kalamazoo MI 49008-4819 |
| Practice Telephone | 2693814760 |
| Mailing Telephone | 2693814760 |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |
| Authorized Official Name | DON NITZ (BOARD ADMINISTRATOR) |
| Authorized Official Telephone | 2693814760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE OF MICHIGAN RESIDENTIAL PROVIDER NUMBER | 6357061 | 01 |
| Other Name | Type Code |
|---|---|
| Lakeside Academy | Doing Business As Name - Organization |
| Street Address |
3921 OAKLAND DR |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49008-4819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144847534 | Theresa Anne Aranda | Pharmacist | 3016 S Westendge Ave, Kalamazoo, MI 49008 | 2020-07-01 |
| 1336615830 | Jonathon Strefling | Physical Therapist | 165 N. Washington Ave, Battle Creek, MI 49008 | 2018-10-23 |
| 1376039826 | Alexander J Hessler I | Pharmacist | 5121 S Westnedge Ave., Kalamazoo, MI 49008 | 2018-07-09 |
| 1700324415 | Philip Richard Granish | Psychologist | 4341 S. Westnedge, Suite 1103, Kalamazoo, MI 49008 | 2017-02-02 |
| 1396195863 | Kyle Bronsteen | Student in an Organized Health Care Education/Training Program | Wmu School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008 | 2016-06-15 |
| 1013363449 | Gwendolyn Layette Moore | Home Health Aide | 4441 Old Colony Road, Kalamazoo, MI 49008 | 2016-05-04 |
| 1982008066 | Danah Kim | Dentist | 3130 N Westnedge Ave., Kalamazoo, MI 49008 | 2014-10-17 |
| 1598168874 | Melissa Shields | Physician Assistant | Western Michigan University, 1903 Western Michigan Avenue, Kalamazoo, MI 49008 | 2014-10-01 |
| 1831508548 | D2 Dental of Michigan, P.C. | Dentist | 3130 S Westnedge Avenue, Kalamazoo, MI 49008 | 2014-08-06 |
| 1558784330 | Maureen Brown | Pharmacist | 5121 S. Westnedge Ave, Kalamazoo, MI 49008 | 2014-01-29 |
| Find all providers in zip 49008 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659621597 | Boys To Men Group Home, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6025 Litchfield Ln, Kalamazoo, MI 49009-9128 | 2012-09-18 |
| 1902156359 | Ian Warnsley | Residential Treatment Facility, Emotionally Disturbed Children | 1204 Jenks Blvd, Kalamazoo, MI 49006-2179 | 2012-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316393408 | Charles and Rose Kelley Open Arms | Residential Treatment Facility, Emotionally Disturbed Children | 718 Somerset Rd, Saginaw, MI 48638-6262 | 2016-05-09 |
| 1063786168 | Adolescence In Motion | Residential Treatment Facility, Emotionally Disturbed Children | 237 N Old Woodward Ave Ste 5, Birmingham, MI 48009-5305 | 2012-03-07 |
| 1518110386 | Don Bosco Hall | Residential Treatment Facility, Emotionally Disturbed Children | 10001 Petoskey Ave, Detroit, MI 48204-3908 | 2008-10-24 |
| 1487841730 | The Salvation Army Denby Center | Residential Treatment Facility, Emotionally Disturbed Children | 20775 Pembroke Ave, Detroit, MI 48219-1345 | 2007-10-01 |
| 1003022922 | Dalila Joy Beard | Residential Treatment Facility, Emotionally Disturbed Children | 2300 N Adrian Hwy, Adrian, MI 49221-1728 | 2007-05-15 |
| 1720123706 | Highfields | Residential Treatment Facility, Emotionally Disturbed Children | 1206 Clinton Rd, Jackson, MI 49202-2005 | 2007-02-20 |
| 1154472710 | Boys & Girls Republic | Residential Treatment Facility, Emotionally Disturbed Children | 28000 W 9 Mile Rd, Farmington Hills, MI 48336-3812 | 2007-01-12 |
| 1659428167 | Methodist Children's Home Society | Residential Treatment Facility, Emotionally Disturbed Children | 26645 W 6 Mile Rd, Redford, MI 48240-2319 | 2007-01-05 |
| 1477639458 | Vista Maria | Residential Treatment Facility, Emotionally Disturbed Children | 20651 W Warren Ave, Dearborn Heights, MI 48127-2622 | 2006-10-31 |
| 1407939010 | Childrens's Home of Detroit | Residential Treatment Facility, Emotionally Disturbed Children | 900 Cook Rd, Grosse Pointe Woods, MI 48236-2713 | 2006-10-24 |
| Find all providers with the same taxonomy | ||||
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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.