NPIMap

Organization Active NPI

Lakeside Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Saint Louis, MO
National Provider Identifier
1841446804
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
LAKESIDE CENTER
Practice address
13044 Marine Ave
Saint Louis, MO 63146-2118
Phone
(314) 434-4535
Fax
(314) 434-9157
NPI assigned
Aug 11, 2008
Last updated
Aug 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rich Swinger
Title
Treatment Director
Phone
(314) 434-4535

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary
Psychiatric Residential Treatment Facility 323P00000X NU
Children's Substance Abuse Rehabilitation Facility 3245S0500X NU

Addresses

Primary practice location

13044 Marine Ave
Saint Louis, MO 63146-2118

Mailing address

13044 Marine Ave
Saint Louis, MO 63146-2118
Phone (314) 434-4535

National Provider Directory

National Provider Directory
Tax ID family
Lakeside Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13044 Marine Ave
Saint Louis, MO 63146
Phone (314) 434-4535

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1841446804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13044 MARINE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631462118",
            "telephone_number": "314-434-4535",
            "fax_number": "314-434-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13044 MARINE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631462118",
            "telephone_number": "314-434-4535",
            "fax_number": "314-434-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "SWINGER",
        "authorized_official_first_name": "RICH",
        "authorized_official_title_or_position": "TREATMENT DIRECTOR",
        "authorized_official_telephone_number": "314-434-4535"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.