LAKESIDE RECOVERY CENTERS INC (NPI# 1801950548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801950548 |
| Entity Type | Organization |
| Organization Name | LAKESIDE RECOVERY CENTERS INC |
| Other Organization Name | LAKESIDE MILAM RECOVERY CENTERS |
| Practice Address |
10322 Ne 132nd St Kirkland WA 98034 |
| Practice Telephone | 4258233116 |
| Practice Fax Number | 4258233132 |
| Mailing Telephone | 4258233116 |
| Mailing Fax Number | 4258233132 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CARLTON M KESTER (PRESIDENT) |
| Authorized Official Telephone | 4258233116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
WA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lakeside Milam Recovery Centers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134292501 | Lakeside Recovery Centers Inc | Substance Abuse Rehabilitation Facility | 12845 Ambaum Blvd Sw, Seattle, WA 98146 | 2006-11-15 |
| 1417020355 | Lakeside Recovery Centers Inc | Substance Abuse Rehabilitation Facility | 10322 Ne 132nd St, Kirkland, WA 98034 | 2006-11-16 |
| Street Address |
10322 NE 132ND ST |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821072356 | Sharon Gail Vanover Wuerth | Nurse Practitioner | 10322 Ne 132nd St, Kirkland, WA 98034-2829 | 2005-11-29 |
| 1639641178 | April Lynn Sterling | Counselor | 10322 Ne 132nd St, Kirkland, WA 98034-2829 | 2018-12-21 |
| 1811468754 | Elissa Lierley | Counselor | 10322 Ne 132nd St, Kirkland, WA 98034-2829 | 2018-12-17 |
| 1184195026 | Katheryn Renay Larson | Counselor | 10322 Ne 132nd St, Kirkland, WA 98034-2829 | 2018-12-17 |
| 1871064329 | Thomas John Blanford | Counselor | 10322 Ne 132nd St, Kirkland, WA 98034-2829 | 2018-12-10 |
| 1265915813 | Catherine Elizabeth Southard | Social Worker | 10322 Ne 132nd St, Kirkland, WA 98034-2829 | 2018-09-10 |
| 1689733883 | Elizabeth Katherine Meloeny | Counselor | 10322 Ne 132nd St, Kirkland, WA 98034-2829 | 2006-12-06 |
| 1417020355 | Lakeside Recovery Centers Inc | Substance Abuse Rehabilitation Facility | 10322 Ne 132nd St, Kirkland, WA 98034 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1780174441 | American Behavioral Health Systems, Inc. | Clinic/Center | 715 E Sprague Ave Ste 107, Spokane, WA 99202-2142 | 2018-05-17 |
| 1598255267 | American Behavioral Healt Systems, Inc. | Clinic/Center | 7208 267th St Nw Ste A-100, Stanwood, WA 98292-6289 | 2018-05-17 |
| 1437648136 | American Behavioral Health Systems, Inc. | Clinic/Center | 8625 Evergreen Way Ste 100, Everett, WA 98208-2620 | 2018-05-08 |
| 1487143350 | Steve Parker | Clinic/Center | 1206 State Ave Ste H, Marysville, WA 98270-3645 | 2018-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.