| Organization Name: | LAKE SHORE BEHAVIORAL HEALTH |
| NPI Number: | 1437565769 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HOWARD HITZEL (PRESIDENT) |
| Mailing Address: | 255 Delaware Ave Suite 300 Buffalo |
| State: | NY US |
| Postal Code: | 142022016 |
| Phone Number: | 7168420440 |
| Fax Number: | 7168424069 |
| NPI Enumeration Date: | 07/08/2014 |
| NPI Last Update Date: | 07/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 324500000X |
| License Number: | 161011304 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |