Great Lakes Recovery Centers
Organization Active NPI Children's Substance Abuse Rehabilitation Facility · Negaunee, MI
NPI 1669899241 · NPPES record last updated Dec 5, 2025
Key facts
- NPI
- 1669899241
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Children's Substance Abuse Rehabilitation Facility 3245S0500X
- Legal business name
- GREAT LAKES RECOVERY CENTERS
- Practice address
- 104 Malton Road
Negaunee, MI 49866 - Phone
- (906) 228-4692
- Fax
- (906) 228-8156
- NPI assigned
- Mar 21, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- GREAT LAKES RECOVERY CENTERS, INC.
Authorized official
- Name
- Greg Toutant
- Title
- Ceo
- Phone
- (906) 228-9699
Other NPIs on the same Medicare enrollment 16
Corporate family (same tax ID) 28
Practitioners 103
-
Trenton Anderson, MSW, DP-AADC
-
Annalise Bartol, LLMSW, CADC
-
Theresa Champion, MA
-
Bailey Lynn Crist, LLMSW
-
Derrick Anthony Depetro, BS, CADC
-
Jamie-Ann Dieterle, LLMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
- Tax ID family
- Great Lakes Recovery Centers
- Part of
- Great Lakes Recovery Centers
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | Yes |
Addresses
Primary practice location
104 Malton Road
Negaunee, MI 49866
Mailing address
100 Malton Rd
Negaunee, MI 49866-2001
Phone (906) 228-9699
Other providers in Negaunee, MI
- Judith Mestnik Gray
- Great Lakes Recovery Centers
- Great Lakes Recovery Centers
- Great Lakes Recovery Centers
- Great Lakes Recovery Centers
- Great Lakes Recovery Centers
- Great Lakes Recovery Centers
- Amy Greeley
- Jaime Racine Green
- Michael S Grossman
All providers in Negaunee, MI · Children's Substance Abuse Rehabilitation Facility in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.