Provider Demographics
NPI:1083687651
Name:UHS OF LAKESIDE LLC
Entity Type:Organization
Organization Name:UHS OF LAKESIDE LLC
Other - Org Name:LAKESIDE BEHAVIORAL HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/ SR VP
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:2911 BRUNSWICK RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4105
Mailing Address - Country:US
Mailing Address - Phone:901-377-4700
Mailing Address - Fax:
Practice Address - Street 1:2911 BRUNSWICK RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-4105
Practice Address - Country:US
Practice Address - Phone:901-377-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN230283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN131599140Medicaid
TN131599140Medicaid
TN444004Medicare Oscar/Certification