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General NPI Number Information
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NPI Number | 1588470033
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Entity Type | Organization
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Legal Business Name | LAKES MENTAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 2814 S GRAND BLVD
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City | SPOKANE
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State | WA
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Zip | 99203-2528
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Country | US
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Telephone | 509-259-8470
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Fax | 509-214-2405
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Provider Business Mailing Address
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Address Line | 2814 S GRAND BLVD
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City | SPOKANE
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State | WA
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Zip | 99203-2528
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Country | US
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Telephone | 509-259-8470
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Fax | 509-212-2405
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Authorized Official
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Title or Position | CEO/PROVIDER
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Name | EMMANUEL DAVIS ALFRED
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Credential |
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Telephone | 214-909-2989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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