LAKESIDE RECOVERY CENTER
NPI 1639682438
Clinic/Center - Rehabilitation, Substance Use Disorder in Sicklerville, NJ
About Lakeside Recovery Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE RECOVERY CENTER (NPI 1639682438) is a healthcare organization registered as a rehabilitation, substance use disorder in Sicklerville, New Jersey and active in the NPI registry since November 2017. The organization holds a CLIA Waiver certificate valid through May 16, 2028 and lists Larry Pettis, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 31D2148743
Sobriety Solutions Lakeside, LLC · Sicklerville, NJFrequently 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 Sobriety Solutions Lakeside LLC's NPI number?
The NPI number for Sobriety Solutions Lakeside LLC is 1639682438. It was assigned to this organization in the NPPES registry on November 15, 2017. The provider is doing business as Lakeside Recovery Center.
Where is Sobriety Solutions Lakeside LLC located?
Sobriety Solutions Lakeside LLC is located at 900 Liberty Pl, Sicklerville, NJ 08081. The listed phone number is (856) 302-1362.
What is Sobriety Solutions Lakeside LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.
Does Sobriety Solutions Lakeside LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 31D2148743) is associated with this NPI, valid through May 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Sobriety Solutions Lakeside LLC was last updated on July 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Lakeside Recovery Center · NPI 1639682438
Rehabilitation, Substance Use Disorder organization in Sicklerville, New Jersey. Organization record, active in the CMS NPPES registry since November 15, 2017.
## Identity
- **NPI:** 1639682438 (Entity type: Organization)
- **Enumerated:** November 15, 2017
- **Primary specialty:** Clinic/Center - Rehabilitation, Substance Use Disorder · taxonomy 261QR0405X
- **Legal business name:** Sobriety Solutions Lakeside Llc
- **Organization subpart:** No
- **Authorized official:** Larry Pettis, MEDICAL DIRECTOR
## Practice location
- **Address:** 900 LIBERTY PL, Sicklerville, NJ 08081-5716
- **Phone:** (856) 302-1362
## Record status
- **NPPES last updated:** July 31, 2023
- **Other identifiers:** Other 2000667 (NJ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1639682438) · Data from the CMS NPPES public registry.