NPIMap

Organization Active NPI

Great Lakes Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Negaunee, MI
National Provider Identifier
1104571900
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
GREAT LAKES RECOVERY CENTERS
Practice address
100 Malton Rd
Suites 1, 2, 3, 4, 5, 6, 7, & 8
Negaunee, MI 49866
Phone
(906) 464-0002
Fax
(906) 464-4043
NPI assigned
Feb 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Greg Miles Toutant, CEO
Title
Chief Executive Officer
Phone
(906) 228-9699

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

100 Malton Rd
Suites 1, 2, 3, 4, 5, 6, 7, & 8
Negaunee, MI 49866

Mailing address

100 Malton Rd
Negaunee, MI 49866-2001
Phone (906) 228-9699

Other names 1

  • Negaunee Service Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101221000468 MI Part B Supplier - Clinic/Group Practice 9133317936 Receives reassigned benefits from 6 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St Ignace, MI; Sault Ste Marie, MI; Iron Mountain, MI; Sault Sainte Marie, MI; Negaunee, MI; Munising, MI; Marquette, MI; L'Anse, MI…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Recovery Centers29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1104571900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALTON RD",
            "city": "NEGAUNEE",
            "state": "MI",
            "postal_code": "498662001",
            "telephone_number": "906-228-9699",
            "fax_number": "906-228-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALTON RD",
            "address_2": "SUITES 1, 2, 3, 4, 5, 6, 7, & 8",
            "city": "NEGAUNEE",
            "state": "MI",
            "postal_code": "49866",
            "telephone_number": "906-464-0002",
            "fax_number": "906-464-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES RECOVERY CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-21",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "TOUTANT",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "MILES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "906-228-9699",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Negaunee Service Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Negaunee Service Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Negaunee, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.