LOST LAKE HEALING NPI 1104732155

NPI Information

  • NPI: 1104732155
  • Provider Name: LOST LAKE HEALING
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 13419 SWISTIER DR
    REMUS, MI
    ZIP 49340
  • Phone: (231) 408-7866

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NPI Details

LOST LAKE HEALING is a mental health (including community mental health center) clinic center in Remus, MI. LOST LAKE HEALING NPI is 1104732155. The provider is registered as an organization entity type.

The provider's business location address is:

13419 SWISTIER DR
REMUS, MI
ZIP 49340-381
Phone: (231) 408-7866

The provider's authorized official is Mckenna Jo Nivison .
The authorized official title is Owner/outpatient Therapist and has the following contact phone number (231) 408-7866.

The enumeration date for this NPI number is 8/20/2026 and was last updated on 8/20/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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