| NPI | 1790552289 |
|---|---|
| Doing Business As | CMS LAKEWOOD |
| Entity Type | Organization |
| Authorized Contact | ALEJANDRA G VILCHIS Credentialing Provider Data Manager 480-977-1438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2024-02-10 |