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Organization
LAKESIDE ABA AZ LLC
Active
Organization
LAKESIDE ABA AZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WILLIAMS PSYD (CEO)
(213) 435-9423
Entity
Organization
Contact information
Practice address
4539 N 22ND ST STE R, PHOENIX, AZ 85016-4639
(410) 357-1840
Mailing address
1500 S DOHENY DR, LOS ANGELES, CA 90035-3211
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
09/26/2025
Last updated
09/26/2025
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