| NPI | 1306585229 |
|---|---|
| Doing Business As | LAKE WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | LEONARD FRANQUES Owner 888-488-5253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-05-31 |