| NPI | 1417557968 |
|---|---|
| Former Legal Business Name | LAKE SHORE MENTAL HEALTH SERVICES, INC. |
| Entity Type | Organization |
| Authorized Contact | ANNETTE N DIGGS President 773-559-0393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2021-04-06 |