LAKESIDE CENTER


Address: 13044 Marine Ave, Saint Louis, MO 63146-2118
Phone: 3144344535

LAKESIDE CENTER (NPI# 1841446804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841446804
Entity Type Organization
Organization Name LAKESIDE CENTER
Practice Address 13044 Marine Ave
Saint Louis
MO 63146-2118
Practice Telephone 3144344535
Practice Fax Number 3144349157
Mailing Telephone 3144344535
Mailing Fax Number 3144349157
Enumeration Date 2008-08-11
Last Update Date 2008-08-11
Authorized Official Name RICH SWINGER (TREATMENT DIRECTOR)
Authorized Official Telephone 3144344535
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 323P00000X Psychiatric Residential Treatment Facility Residential Treatment Facilities
N 3245S0500X Substance Abuse Rehabilitation Facility
Specialization: Substance Abuse Treatment, Children
Residential Treatment Facilities
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children Residential Treatment Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1043697832 Lakeside Center Counselor 6515 George Washington Mem Hwy, # 101, Yorktown, VA 23692-2182 2015-04-30

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations LAKESIDE CENTER FOR AUTISM LLC 5150 Village Park Dr Se, Ste 200, Bellevue, WA 98006
Colorado Business Entities Lakeside Center Public Improvement Company 211 N. Stadium Blvd., Suite 201, Columbia, MO 65203
Massachusetts Corporations LAKESIDE CENTER, LLC 1436 Iyannough Road, Hyannis, MA 02601
Colorado Business Entities LAKESIDE CENTER, LLC 211 N Stadium Blvd Ste 201, Columbia, MO 65203

Office Location

Street Address 13044 MARINE AVE
City SAINT LOUIS
State MO
Zip Code 63146-2118

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700256609 Camillia Williams Counselor 13044 Marine Ave, Saint Louis, MO 63146-2118 2015-10-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316553118 Chelsea Ann Garbs Nurse Practitioner 1249 Woodland Point Dr Unit E, St. Louis, MO 63146 2020-09-17
1538790647 Supreme Quality Care LLC Home Health 111 West Port Plaza, Floor 6, Maryland Heights, MO 63146 2020-01-28
1942854492 Winning Hands Home Health Care Services LLC In Home Supportive Care 12738 Fee Fee Rd, Saint Louis, MO 63146 2019-08-01
1144883893 Tylians T Smith Physical Therapy Assistant 12544 Fee Fee Rd, Saint Louis, MO 63146 2019-04-18
1528533049 Veterans Home Care, LLC Durable Medical Equipment & Medical Supplies 11861 Westline Industrial Drive, Suite 750, St. Louis, MO 63146 2018-10-11
1417433558 Alexandria Marie Falck Pharmacist 577 Mid Rivers Mall Drive, Saint Louis, MO 63146 2018-07-12
1043702897 Equal Shares Parenting, LLC Marriage & Family Therapist 10313 Corbeil Dr., Unit D, St. Louis, MO 63146 2018-06-06
1588189930 Anita Shawke Physical Therapist 11960 Westline Industrial Drive, Suite 201, St. Louis, MO 63146 2017-08-07
1174047005 Midwest Spine & Injury Centers, Inc. Chiropractor 2108 Schuetz Road, Maryland Heights, MO 63146 2017-08-02
1447700604 Compassus Op of Missouri LLC Hospice Care, Community Based 11872 Westline Industrial Dr Ste 160, Saint Louis, MO 63146 2016-10-11
Find all providers in zip 63146

Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659558054 General Assembly of The Christian Church Disciples of Christ St. Louis Residential Treatment Facility, Emotionally Disturbed Children 3033 N Euclid Ave, Saint Louis, MO 63115-1632 2008-01-28
1093881252 Good Shepherd Children and Family Services Residential Treatment Facility, Emotionally Disturbed Children 1340 Partridge Ave, Saint Louis, MO 63130-1943 2006-11-28
1790879617 Presbyterian Children's Services Residential Treatment Facility, Emotionally Disturbed Children 1353 N Warson Rd, Saint Louis, MO 63132-1807 2006-10-03
1679578413 Child Center of Our Lady Residential Treatment Facility, Emotionally Disturbed Children 7900 Natural Bridge Rd, Saint Louis, MO 63121-4628 2005-06-17
1578098489 St. Vincent Home for Children Residential Treatment Facility, Emotionally Disturbed Children 7401 Florissant Rd, Saint Louis, MO 63121-4835 2017-04-28
1225388465 Great Circle- Edgewood Children's Center Residential Treatment Facility, Emotionally Disturbed Children 330 N Gore Ave, Saint Louis, MO 63119-1600 2012-09-14
1801109343 Children's Foundation of Mid America Residential Treatment Facility, Emotionally Disturbed Children 1353 N Warson Rd, Saint Louis, MO 63132-1807 2010-07-26
1467781393 Covenant House Missouri Residential Treatment Facility, Emotionally Disturbed Children 2727 N Kingshighway Blvd, Saint Louis, MO 63113-1006 2009-12-24
1780846451 Susie Dietz Mcgaughey Residential Treatment Facility, Emotionally Disturbed Children 330 N Gore Ave, Saint Louis, MO 63119-1600 2008-06-25
1104093681 German St. Vincent Orphan Association Residential Treatment Facility, Emotionally Disturbed Children 7401 Florissant Rd, Saint Louis, MO 63121-4835 2008-05-13
Find all providers in SAINT LOUIS

Competitor

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City SAINT LOUIS
Zip Code 63146

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Dataset Information

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.

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