| NPI | 1700901022 |
|---|---|
| Doing Business As | LAKESIDE LIFE CENTER |
| Entity Type | Organization |
| Authorized Contact | DEBBIE K. JOHNSON Office Manager 972-221-1741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX F2490) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2011-08-03 |