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LAKESIDE LIFE RECOVERY, LLC
NPI 1609171008
Substance Abuse Rehabilitation Facility in Newark, TX

Active since January 14, 2011
341 COUNTY ROAD 4874, NEWARK, TX 76071(817) 831-4673 Get Directions Write a Review

NPPES record last updated: January 14, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lakeside Life Recovery, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE LIFE RECOVERY, LLC (NPI 1609171008) is a healthcare organization registered as a substance abuse rehabilitation facility in Newark, Texas and active in the NPI registry since January 2011. The organization lists Don Perry Johnson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1609171008
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameLAKESIDE LIFE RECOVERY, LLC
Location Address341 COUNTY ROAD 4874Newark, TX 76071-3715
Mailing Address2909 Race StFort Worth, TX 76111-4134 · (817) 831-4673
Phone(817) 831-4673
Organization SubpartNo
Authorized OfficialDon Perry JohnsonExecutive Director · (972) 754-6257
Enumeration DateJanuary 14, 2011
✔ NPI 1609171008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
341 COUNTY ROAD 4874, Newark, TX 76071
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeside Life Recovery, LLC's NPI number?

The NPI number for Lakeside Life Recovery, LLC is 1609171008. It was assigned to this organization in the NPPES registry on January 14, 2011.

Where is Lakeside Life Recovery, LLC located?

Lakeside Life Recovery, LLC is located at 341 County Road 4874, Newark, TX 76071. The listed phone number is (817) 831-4673.

What is Lakeside Life Recovery, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Lakeside Life Recovery, LLC was last updated on January 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.