Lakeshore Wellness And Recovery Inc
LBN: Lakeshore Wellness And Recovery Inc
Lakeshore Wellness And Recovery Inc is an health care organization with primary practice located at 1519 E Washington St Ste A , West Bend WI 53095-2615. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is the primary health care specialty.
Lakeshore Wellness And Recovery Inc can be contacted via phone (262) 305-9668, or through Nowak, Lynn via phone (262) 305-9668.
Contact Information
Primary practice address
1519 E Washington St Ste A
West Bend WI 53095-2615
Phone: (262) 305-9668
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 15917-132 | Wisconsin |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 6584-125 | Wisconsin |
Profile Details
| NPI number | 1609355452 |
|---|---|
| LBN Legal business name | Lakeshore Wellness And Recovery Inc |
| DBA Doing business as | |
| Authorized official | Nowak, Lynn LPC, CSAC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 13th, 2018 |
| Last updated | Nov 2nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609355452 | NPPES |
| Wisconsin | MEDICAID | 1962748624 |
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