Organization
LAKESIDE RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLLIS WEINSTEIN MSW,MED,LCSW,LPC,LCA (DIR OF TREATMENT SERVICE)
(856) 302-1362
Entity
Organization
Contact information
Practice address
200 INDEPENDENCE BLVD, SICKLERVILLE, NJ 08081-1092
(856) 302-1362
Mailing address
200 INDEPENDENCE BLVD, SICKLERVILLE, NJ 08081-1092
(856) 302-1362
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2000527-11
NJ
Other
Enumeration date
01/10/2012
Last updated
10/14/2013
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