Organization
THE LAKES AT BLACK CREEK
Active
Parent organization
THE LAKES TREATMENT CENTER INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE LAKES TREATMENT CENTER INC
Authorized official
NICHOLAS J MCNULTY (COMPLIANCE DIRECTOR)
(209) 768-5871
Entity
Organization
Contact information
Practice address
88 SANGUINETTI CT, COPPEROPOLIS, CA 95228-9459
(209) 325-8506
Mailing address
7260 OBYRNES FERRY RD, COPPEROPOLIS, CA 95228-9761
(209) 325-8535
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
050005BP
CA
Other
Enumeration date
04/13/2017
Last updated
11/09/2017
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