Organization
LAKESIDE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVIT GASPARYAN (CEO)
(661) 383-9193
Entity
Organization
Contact information
Practice address
30347 JUNE ROSE CT, CASTAIC, CA 91384-4738
(661) 383-9193
Mailing address
30347 JUNE ROSE CT, CASTAIC, CA 91384-4738
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/03/2025
Last updated
04/18/2025
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