GREAT LAKES RECOVERY CENTERS NPI 1588833404

NPI Information

NPI: 1588833404
Provider Name: GREAT LAKES RECOVERY CENTERS
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
2655 ASHMUN ST
SAULT SAINTE MARIE, MI
ZIP 49783
Phone: (906) 632-9809
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GREAT LAKES RECOVERY CENTERS is a substance abuse rehabilitation facility in Sault Sainte Marie, MI. The provider is 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. GREAT LAKES RECOVERY CENTERS NPI is 1588833404. The provider is registered as an organization entity type.

The provider's business location address is:

2655 ASHMUN ST
SAULT SAINTE MARIE, MI
ZIP 49783-711
Phone: (906) 632-9809
Fax: (906) 632-2370

The provider's authorized official is Gregory Miles Toutant .
The authorized official title is Executive Director and has the following contact phone number (906) 228-9699.

The enumeration date for this NPI number is 2/25/2008 and was last updated on 12/28/2023.

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
1	324500000X	Substance Abuse Rehabilitation Facility		170045	MICHIGAN	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3272541	MEDICAID	MICHIGAN

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: 5/5/2024

NPI Synchronization or Removal

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