National Provider Identifier Database

GREAT LAKES RECOVERY CENTERS
Rehabilitation, Substance Use Disorder


Contact Information

GREAT LAKES RECOVERY CENTERS
1101 LUDINGTON ST. SUITE H
ESCANABA, MI49829
Phone: 906-789-3528
Fax: 906-786-9801
Website:
Specialty Taxonomy Code
* Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for GREAT LAKES RECOVERY CENTERS

NPI Number 1679714083
Legal business name
LBN
GREAT LAKES RECOVERY CENTERS
Authorized official GREG TOUTANT - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart Yes
Enumeration date 03/13/2009
Last updated 12/05/2025 - About 6 months ago
Sole proprietor1 Not specified
Identifiers
  • MI License #: 210024
  • MI Medicaid: 3272541

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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