| NPI | 1396895496 |
|---|---|
| Former Legal Business Name | LAKESIDE RECOVERY CENTERS OF SPOKANE, INC. |
| Entity Type | Organization |
| Authorized Contact | MISTY ARLENE SUSAN VICKERS Office Manager 509-328-5234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WA 32035100) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2022-10-14 |