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GREAT LAKES ADDICTION RECOVERY SERVICES PLLC NPI 1568084333


NPI Information

NPI: 1568084333
Provider Name: GREAT LAKES ADDICTION RECOVERY SERVICES PLLC
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
142 E MAUMEE ST
ADRIAN, MI
ZIP 49221
Phone: (517) 306-2244
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GREAT LAKES ADDICTION RECOVERY SERVICES PLLC is an addiction medicine family medicine in Adrian, MI. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. GREAT LAKES ADDICTION RECOVERY SERVICES PLLC NPI is 1568084333. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

142 E MAUMEE ST
ADRIAN, MI
ZIP 49221-735
Phone: (517) 306-2244
Fax: (866) 465-0269

The provider's authorized official is Robyn M Jones .
The authorized official title is Business Manager and has the following contact phone number (517) 306-2244.

The enumeration date for this NPI number is 5/14/2020 and was last updated on 5/14/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QA0401XFamily MedicineAddiction MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1104719902MEDICAIDMICHIGAN

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: 4/28/2024

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