Organization Name: | LAKESIDE BILLING SERVICES |
NPI Number: | 1033505011 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHANNA SALTER (OWNER) |
Mailing Address: | 6280 W 9600 N Highland |
State: | UT US |
Postal Code: | 840039234 |
Phone Number: | 8017037289 |
Fax Number: | 8018557207 |
NPI Enumeration Date: | 04/07/2015 |
NPI Last Update Date: | 04/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |