North Shores Center, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

NORTH SHORES CENTER, LLC

Doing business as

Alpine Adult CRU

Practice address

118 McLouth Rd
Gaylord, MI 49735-9339

Phone

(989) 598-7435

NPI assigned

Jan 16, 2024

Last updated

Jan 16, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTH SHORES CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Jill Lebourdais, PA-CNPI 1447216999

Title

Director of Clinical Servicee

Phone

(989) 493-1451

Specialties & licenses 1

Addresses

Other names 1

• Alpine Adult CRU Doing business as

Tax ID family

North Shores Center LLC2 organizations share this tax ID, including this one

Part of

North Shores Center LLC

Other organizations with this tax ID 1

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

• North Shores Center, LLC

  • Adult Mental Health Clinic/Center
  • Oscoda, MI
  • NPI 1962060541
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• North Shores Center, LLC

  • Adult Mental Health Clinic/Center
  • Oscoda, MI
  • NPI 1962060541
  NPPES parent name

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.

• Jill Anne Lebourdais, PA

  • Medical Physician Assistant
  • Saginaw, MI
  • NPI 1447216999
  NPD Authorized official

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1700657905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 WINTERWOOD LN",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486038673",
            "telephone_number": "989-493-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MCLOUTH RD",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359339",
            "telephone_number": "989-598-7435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORES CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH SHORES CENTER, LLC",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "LEBOURDAIS",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICEE",
        "authorized_official_telephone_number": "989-493-1451",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpine Adult CRU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eugene Leo Niedzwiecki, RPH
• Melissa Mary Emerald Noa, FNP
• Gilbert Alan Noirot, M.D.
• Aaron Joseph Nolan, FNP
• Kira Norris
• Northern Family Intervention Services, Inc.
• Northern Management Services LTD
• Northern Management Services, LTD.
• Northern Michigan Chiropractic Center, PLC (Oliver Chiropractic Clinic)
• Northern Michigan Family Dentistry PLLC (Gaylord Family Dentistry)

• Psychiatric Residential Treatment Facility in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Psychiatric Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.