Healthcare Provider Details
I. General information
NPI: 1851208847
Provider Name (Legal Business Name): LAKESIDE HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2890 ELLA LN
MINNETONKA MN
55305-3902
US
IV. Provider business mailing address
30310 RANCHO VIEJO RD
SAN JUAN CAPISTRANO CA
92675-1576
US
V. Phone/Fax
- Phone: 833-589-5150
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
FARBMAN
Title or Position: SR DIRECTOR RCM
Credential:
Phone: 949-301-2863