LAKESIDE LIFE RECOVERY, LLC – Substance Abuse Rehabilitation Facility, NPI 1609171008

LAKESIDE LIFE RECOVERY, LLC is a healthcare provider. based in Fort worth, Texas. specializing in Substance Abuse Rehabilitation Facility. The NPI Number for LAKESIDE LIFE RECOVERY, LLC is 1609171008

Main info

Organization
Name
LAKESIDE LIFE RECOVERY, LLC
NPI
1609171008
Phone
(817) 831-4673
Address
2909 RACE ST
Authorized Official
MR. DON PERRY JOHNSON SR. EXECUTIVE DIRECTOR
Enumeration Date
14 January 2011
Last Update Date
14 January 2011
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:15State licenses:0Digital endpointsOther names

Provider Addresses for LAKESIDE LIFE RECOVERY, LLC

  • 2909 RACE ST

    FORT WORTH, TX 761114134

    Phone: (817) 831-4673

    Type: Mailing

  • 341 COUNTY ROAD 4874

    NEWARK, TX 760713715

    Phone: (817) 831-4673

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76111)

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Reviews

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Frequently asked questions

Does LAKESIDE LIFE RECOVERY, LLC have a public NPI I can cite?
Public records show LAKESIDE LIFE RECOVERY, LLC under NPI 1609171008.
Quick check: is LAKESIDE LIFE RECOVERY, LLC active?
Public NPPES data shows LAKESIDE LIFE RECOVERY, LLC with an active NPI status right now.
How should patients interpret LAKESIDE LIFE RECOVERY, LLC's specialty?
The extract shows Substance Abuse Rehabilitation Facility for LAKESIDE LIFE RECOVERY, LLC. Clinical services aligned with this taxonomy classification.
Which community is linked to LAKESIDE LIFE RECOVERY, LLC?
LAKESIDE LIFE RECOVERY, LLC shows a connection to Fort Worth, Texas in registry-derived data.
Can I export LAKESIDE LIFE RECOVERY, LLC's record?
You can download the official NPPES record; we summarize key fields for readability.

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