NPI 1154048320

Lakeshore Pond LLC

Organisation Mental Illness Community Based Residential Treatment Facility Cleveland, OH

Practice location

Address: 1757 Wickford Rd, Cleveland, OH 44112-1207
Phone: (216) 245-8550
Mailing address: 25000 Euclid Ave STE 401, Euclid, OH 44117-2645

Authorised official

Name: Shashonna Duckworth
Title: Director of Operations
Phone: (216) 245-8550

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Ohio →

Registry record

NPI: 1154048320
Entity type: Organization
NPI issued: 27 Oct 2022
Record last updated: 7 Dec 2022

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.