Healthcare Provider Details

I. General information

NPI: 1033155833
Provider Name (Legal Business Name): LAKEVIEW MENTAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W WASHINGTON ST
GENEVA NY
14456-2120
US

IV. Provider business mailing address

600 W WASHINGTON ST
GENEVA NY
14456-2120
US

V. Phone/Fax

Practice location:
  • Phone: 315-789-5501
  • Fax: 315-789-5515
Mailing address:
  • Phone: 315-789-5501
  • Fax: 315-789-5515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNY

VIII. Authorized Official

Name: MRS. BRAEDY DELROSSA
Title or Position: CONTROLLER
Credential:
Phone: 585-294-2900