| NPI | 1578951596 |
|---|---|
| Doing Business As | LAKESIDE COUNSELING AND WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | PATRICIA ADAMS Owner 386-333-9717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2022-03-07 |