Grand Traverse Resource Center

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

GRAND TRAVERSE RESOURCE CENTER

Practice address

1209 E 8TH St
Traverse City, MI 49686-2938

Phone

(231) 360-8705

Fax

(231) 252-4494

NPI assigned

Jul 3, 2023

Organization subpart

No

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

Authorized official

Name

Colette Grace Stephenson

Title

Ceo

Phone

(231) 360-8705

Specialties & licenses 3

Addresses

Other names 1

• GRAND TRAVERSE RESOURCE CENTER Former legal business name

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1558048207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862938",
            "telephone_number": "231-360-8705",
            "fax_number": "231-252-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862938",
            "telephone_number": "231-360-8705",
            "fax_number": "231-252-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TRAVERSE RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-360-8705"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAND TRAVERSE RESOURCE CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Developmentally Disabled Services Day Training Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.