GREAT LAKES RECOVERY CENTER (NPI# 1588020374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588020374 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES RECOVERY CENTER |
| Practice Address |
1009 W Ridge St Suite C Marquette MI 49855-3997 |
| Mailing Address |
97 S 4th St Suite C Ishpeming MI 49849-2168 |
| Practice Telephone | 9062286545 |
| Mailing Telephone | 9062289699 |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |
| Authorized Official Name | MS. JULIE ANN SALO (SUPERVISOR) |
| Authorized Official Telephone | 9062289696 |
| Authorized Official Credential | CADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
6801098960 | MI | Ambulatory Health Care Facilities |
| Street Address |
1009 W RIDGE ST SUITE C |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855-3997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639342504 | Michael G Lasich Pllc | Chiropractor | 1009 W Ridge St, Suite B, Marquette, MI 49855-3997 | 2008-04-10 |
| 1245735323 | Josephine Hedglen | Counselor | 1009 W Ridge St, Marquette, MI 49855-3997 | 2018-03-29 |
| 1932637006 | Ed Deyo | Counselor | 1009 W Ridge St, Marquette, MI 49855-3997 | 2017-06-01 |
| 1235506924 | Nichole Katherine Nelson | Counselor | 1009 W Ridge St, Marquette, MI 49855-3997 | 2015-08-28 |
| 1922440593 | Elise Marie Bunce | Registered Nurse | 1009 W Ridge St, Marquette, MI 49855-3997 | 2013-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
| Find all providers in zip 49855 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1093210551 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 2424 W Washington Ave Ste 100, Jackson, MI 49203-1236 | 2018-03-27 |
| 1861862641 | Michigan Forensic Intervention Services | Clinic/Center | 21821 Lakeview St, Saint Clair Shores, MI 48080-4057 | 2015-10-06 |
| 1396149068 | Crc Recovery, Inc. | Clinic/Center | 522 South Maple Road, Ann Arbor, MI 48103-3837 | 2014-10-09 |
| 1679714083 | Great Lakes Recovery Centers, Inc. | Clinic/Center | 1401 N. 26th Street, Suite 109, Escanaba, MI 49801 | 2009-03-13 |
| 1962606632 | St Johns Home | Clinic/Center | 2355 Knapp St Ne, Grand Rapids, MI 49505-4415 | 2007-06-14 |
| 1699981498 | West Michigan Therapy Inc | Clinic/Center | 130 E Apple Ave, Muskegon, MI 49442-3405 | 2007-05-16 |
| 1982810024 | Community Healing Center | Clinic/Center | 816 East Michigan Ave, Suite 103, Paw Paw, MI 49079-1215 | 2007-05-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.