NPIMap

Organization Active NPI

Great Lakes Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Escanaba, MI
National Provider Identifier
1679714083
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
210024 Issued in MI
Legal business name
GREAT LAKES RECOVERY CENTERS
Practice address
1101 Ludington St. Suite H
Escanaba, MI 49829
Phone
(906) 789-3528
Fax
(906) 786-9801
NPI assigned
Mar 13, 2009
Last updated
Dec 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT LAKES RECOVERY CENTERS, INC.As reported in NPPES

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
Mr. Greg M Toutant
Title
Chief Executive Officer
Phone
(906) 228-9699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 210024 MI Primary

Addresses

Primary practice location

1101 Ludington St. Suite H
Escanaba, MI 49829

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3272541MedicaidMI

Other names 1

  • Escanaba Outpatient 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
Part of
Great Lakes Recovery Centers

Other organizations with this tax ID 28

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

View all 28

Locations

1101 Ludington St
Ste H
Escanaba, MI 49829
Phone (906) 789-3528

1401 N 26th St
Ste 109
Escanaba, MI 49829

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1679714083",
    "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": "1101 LUDINGTON ST. SUITE H",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-789-3528",
            "fax_number": "906-786-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES RECOVERY CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT LAKES RECOVERY CENTERS, INC.",
        "enumeration_date": "2009-03-13",
        "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": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "906-228-9699",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MI",
            "license": "210024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3272541",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Escanaba Outpatient",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Escanaba, 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.