Lake Shore Center for Behavioral Health, LLC

NPI #1497011456 in Waco, Texas

Provider Information

NPI Number: 1497011456
Entity Type: Organization
Organization Name: Lake Shore Center for Behavioral Health, LLC
Primary Specialty: Clinic/Center - Adult Mental Health
Enumeration Date: Apr 4, 2012
Last Updated: Apr 4, 2012

Practice Location

Address: 4555 LAKE SHORE DR
City: Waco
State: Texas
ZIP Code: 76710-1814
Phone: (254) 776-0400

Authorized Official

Name: DR. RICK PIPKIN, LPC
Title: CHIEF EXECUTIVE OFFICER
Phone: (254) 776-0400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X	Primary

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