Great Lakes Recovery Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GREAT LAKES RECOVERY CENTER LLC

Practice address

2575 Hayes Ave
Fremont, OH 43420-5201

Phone

(567) 280-9435

NPI assigned

Apr 28, 2020

Last updated

Oct 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Guardiola, LISW-S

Title

Executive Director

Phone

(567) 280-9435

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher Juan Jordan, LPCC-S

  • Addiction (Substance Use Disorder) Counselor
  • Fremont, OH
  • NPI 1073913455
  NPD

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1497376735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 N BROADWAY ST",
            "city": "GREEN SPRINGS",
            "state": "OH",
            "postal_code": "448369689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 HAYES AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434205201",
            "telephone_number": "567-280-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-28",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "GUARDIOLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "567-280-9435",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Ann Gladieux, LPN
• Jamie Gnagy
• Lora Jean Goebel, SLP
• Michaelle Ann Goodman
• Great Lakes Community Action Partnership
• Courtney Renee Greenwood, DMD
• Danielle Nicole Grieb, APRN-CNP
• Michael Emanuel Grillis, DO
• Grund Drug Co
• David Guardiola, MSW, LISW

• Substance Abuse Rehabilitation Facility in Fremont, OH
• Providers in Fremont, OH by specialty
• Substance Abuse Rehabilitation Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.