GREAT LAKES RECOVERY CENTERS, INC.


Address: 1401 N. 26th Street, Suite 109, Escanaba, MI 49801
Phone: 9067893528

GREAT LAKES RECOVERY CENTERS, INC. (NPI# 1679714083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679714083
Entity Type Organization
Organization Name GREAT LAKES RECOVERY CENTERS, INC.
Practice Address 1401 N. 26th Street
Suite 109
Escanaba
MI 49801
Mailing Address 97 S 4th St
Suite C
Ishpeming
MI 49849-2168
Practice Telephone 9067893528
Practice Fax Number 9067869801
Mailing Telephone 9062289699
Mailing Fax Number 9062280505
Enumeration Date 2009-03-13
Last Update Date 2014-06-25
Authorized Official Name MR. GREG M TOUTANT (CEO)
Authorized Official Telephone 9062289699
Is Organization Subpart Y
Parent Organization Name GREAT LAKES RECOVERY CENTERS, INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
210024 MI Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MI 3272541 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1669899241 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 104 Malton Road, Negaunee, MI 49866 2014-03-21
1922300714 Great Lakes Recovery Centers, Inc. Community/Behavioral Health 3120 10th Street, Suite 2, Menominee, MI 49858 2010-11-30
1619202447 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 413 Maple Street, Suite 2, Munising, MI 49862 2009-10-13
1902131733 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 396 N. State Street, 4th Floor, St. Ignace, MI 49781 2009-10-13
1629303441 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 601 Lakeshore Drive, Suite 101, Manistique, MI 49854 2009-10-13
1679742597 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 2655 Ashmun St., Sault Ste. Marie, MI 49783 2008-02-25
1932378858 Great Lakes Recovery Centers, Inc. Clinic/Center 241 Wright Street, Marquette, MI 49855 2008-02-25
1801065925 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 301 E Spruce St, Sault Sainte Marie, MI 49783-2134 2008-02-22
1821267956 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 220 Rooselvelt Street, Ironwood, MI 49938 2008-02-22
1215106349 Great Lakes Recovery Centers, Inc. Substance Abuse Rehabilitation Facility 427 S. Stephenson Avenue, Suite 214, Iron Mountain, MI 49938 2008-02-22

Office Location

Street Address 1401 N. 26TH STREET
SUITE 109
City ESCANABA
State MI
Zip Code 49801

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1831349539 Amanda Jane Petti Dietitian, Registered 300 E H Street, Nutrition & Food Service, Iron Mountain, MI 49801 2008-09-30
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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1962606632 St Johns Home Clinic/Center 2355 Knapp St Ne, Grand Rapids, MI 49505-4415 2007-06-14
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Competitor

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City ESCANABA
Zip Code 49801

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Dataset Information

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.

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