GREAT LAKES RECOVERY CENTERS, INC. (NPI# 1821267956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821267956 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES RECOVERY CENTERS, INC. |
| Practice Address |
220 Rooselvelt Street Ironwood MI 49938 |
| Mailing Address |
97 S 4th St Suite C Ishpeming MI 49849-2168 |
| Practice Telephone | 9063647506 |
| Practice Fax Number | 9063647508 |
| Mailing Telephone | 9062289699 |
| Mailing Fax Number | 9062280505 |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2014-06-25 |
| Authorized Official Name | GREG TOUTANT (CEO) |
| Authorized Official Telephone | 9062289699 |
| Is Organization Subpart | Y |
| Parent Organization Name | GREAT LAKES RECOVERY CENTERS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | 270032 | MI | Residential Treatment Facilities |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | MI00719 | MI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3272541 | 05 |
| 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 |
| 1679714083 | Great Lakes Recovery Centers, Inc. | Clinic/Center | 1401 N. 26th Street, Suite 109, Escanaba, MI 49801 | 2009-03-13 |
| 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 |
| 1215106349 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 427 S. Stephenson Avenue, Suite 214, Iron Mountain, MI 49938 | 2008-02-22 |
| Street Address |
220 ROOSELVELT STREET |
| City | IRONWOOD |
| State | MI |
| Zip Code | 49938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891319661 | Jonathon Rulseh | Physical Therapy Assistant | 10561 Grandview Ln, Ironwood, MI 49938 | 2020-06-08 |
| 1295107704 | Susanna Lee Harris | Counselor | 220 Roosevelt St, Ironwood, MI 49938 | 2015-10-22 |
| 1609214600 | Eve J. Komosa | Physician Assistant | N. 10561 Grand View Lane, Aspirus Grand View, Ironwood, MI 49938 | 2013-06-12 |
| 1255629861 | Tatyana G Bombard | Radiology | Aspirus Ironwood Hospital, N10561 Grand View Lane, Ironwood, MI 49938 | 2011-07-17 |
| 1205140761 | Allison Harr | Advanced Practice Midwife | N 10565 Grandview Lane, Ironwood, MI 49938 | 2010-07-27 |
| 1215106349 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 427 S. Stephenson Avenue, Suite 214, Iron Mountain, MI 49938 | 2008-02-22 |
| 1740466176 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 10305 Country Club Road, Ironwood, MI 49938 | 2008-01-16 |
| 1396811121 | Rebecca Lynn Mika | Occupational Therapist | 1310 E Cloverland Dr, Ironwood, MI 49938 | 2006-11-24 |
| 1306940432 | Marsha Miller Toohey | Chiropractor | 129 E Ayer St, Ironwood, MI 49938 | 2006-09-11 |
| 1326091406 | Sheri L Ewing | Family Medicine | 629 W Cloverland Dr Ste 1, Ironwood, MI 49938 | 2006-05-18 |
| Find all providers in zip 49938 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| 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. |
| Notes: [7/1/2003: modified title, modified definition] |
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| 1366063810 | Nc Recovery House LLC | Substance Abuse Rehabilitation Facility | 777 Colfax Ave, Benton Harbor, MI 49022-7406 | 2020-05-06 |
| 1235789074 | Green Castle Recovery Centers, LLC. | Substance Abuse Rehabilitation Facility | 233 Fulton St E Ste 101, Grand Rapids, MI 49503-3262 | 2019-09-13 |
| 1043773047 | New Paths, Inc. | Substance Abuse Rehabilitation Facility | 909 Martin Luther King Ave, Flint, MI 48503-1488 | 2019-04-08 |
| 1831651330 | Bethany House Recovery House | Substance Abuse Rehabilitation Facility | 722 S Rose St, Kalamazoo, MI 49007-5216 | 2019-04-03 |
| 1639631138 | Hope House Recovery House | Substance Abuse Rehabilitation Facility | 131 S Nottawa St, Sturgis, MI 49091-1736 | 2019-04-03 |
| 1811459324 | Healing House | Substance Abuse Rehabilitation Facility | 721 S Rose St Apt B, Kalamazoo, MI 49007-6200 | 2019-04-03 |
| 1669932109 | Inner Man Wellness and Support Services | Substance Abuse Rehabilitation Facility | 4890 Ballantrae Rd, Bloomfield, MI 48301-1000 | 2019-03-21 |
| 1528526266 | Mid-michigan Recovery Center | Substance Abuse Rehabilitation Facility | 3821 N Grant Ave, Harrison, MI 48625-9606 | 2019-03-12 |
| 1316410681 | The Light Treatment & Rehabilitation LLC | Substance Abuse Rehabilitation Facility | 5380 Kreger St, Sterling Heights, MI 48310-5728 | 2019-01-09 |
| 1306321179 | Yarrow Lodge, LLC | Substance Abuse Rehabilitation Facility | 10677 N 48th Street, Augusta, MI 49012 | 2018-09-27 |
| 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.