Organization
LAKESIDE EDUCATIONAL SEMINARS AND SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JOHN MALONEY PHD, LCSW (OWNER)
(205) 471-5388
Entity
Organization
Contact information
Practice address
3400 HIGHWAY 78 E, DR MALONEY NEXT TO SENIOR CARE, JASPER, AL 35501-8907
(205) 471-5388
(205) 208-1709
Mailing address
2101 3RD AVE S, UNIT 411, JASPER, AL 35502-5001
(205) 471-5388
(205) 208-1709
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2349C
AL
Other
Enumeration date
11/10/2014
Last updated
12/11/2014
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