NPI 1023430519
Lake Shore Treatement Center LLC
Practice location
- Address
- 140 Quail St, Mahtomedi, MN 55115-1941
- Phone
- (612) 326-7600
- Mailing address
- 550 Main St STE 230, New Brighton, MN 55112-3274
Authorised official
- Name
- Lewis P Zeidner
- Title
- Ceo
- Phone
- (763) 245-8278
Registered specialties
Substance Abuse Rehabilitation Facility
Primary
Registry record
- NPI
- 1023430519
- Entity type
- Organization
- NPI issued
- 17 Jan 2014
- Record last updated
- 20 Feb 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.