Organization
LAKE SHORE TREATEMENT CENTER LLC
Active
Organization
LAKE SHORE TREATEMENT CENTER LLC
Active
Other names
Eosis Lakeshore
Organization subpart
No
Provider details
NPI number
Authorized official
LEWIS P ZEIDNER PHD (CEO)
(763) 245-8278
Entity
Organization
Contact information
Practice address
140 QUAIL ST, MAHTOMEDI, MN 55115-1941
(612) 326-7600
Mailing address
550 MAIN ST STE 230, NEW BRIGHTON, MN 55112-3274
(612) 326-7600
(651) 631-3231
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1067244
MN
Other
Enumeration date
01/17/2014
Last updated
02/20/2025
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