Organization
LAKE SHORE CENTER FOR BEHAVIORAL HEALTH, LLC
Active
Organization
LAKE SHORE CENTER FOR BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICK PIPKIN LPC (CHIEF EXECUTIVE OFFICER)
(254) 776-0400
Entity
Organization
Contact information
Practice address
4555 LAKE SHORE DR, WACO, TX 76710-1814
(254) 776-0400
Mailing address
4555 LAKE SHORE DR, WACO, TX 76710-1814
(254) 776-0400
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
9878
TX
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
3023
TX
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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