Lakeside Csu
NPI #1518324128 in Bloomingdale, Georgia
Provider Information
- NPI Number
- 1518324128
- Entity Type
- Organization
- Organization Name
- Lakeside Csu
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Jan 27, 2016
- Last Updated
- Jan 27, 2016
Practice Location
- Address
- 600 DOT BARN RD
- City
- Bloomingdale
- State
- Georgia
- ZIP Code
- 31302-9353
- Phone
- (912) 449-7109
Authorized Official
- Name
- MICHELLE SIMPSON
- Title
- BILLING MANAGER
- Phone
- (912) 449-7109
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Residential Treatment Facility |
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