NPIMap

Organization Active NPI

Great Lakes Recovery Centers

Doing business as Teal Lake Women's Residential

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Negaunee, MI
National Provider Identifier
1790558286
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
GREAT LAKES RECOVERY CENTERS
Doing business as
Teal Lake Women's Residential
Practice address
100 Malton Rd Ste 1
Negaunee, MI 49866-2002
Phone
(906) 451-4889
Fax
(906) 228-8156
NPI assigned
Nov 6, 2023
Last updated
Dec 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT LAKES RECOVERY CENTERS, INCAs 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
Laura Urias Giuchin
Title
Senior Accountant
Phone
(906) 228-9699

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

100 Malton Rd Ste 1
Negaunee, MI 49866-2002

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3272541MedicaidMI

Other names 1

  • Teal Lake Women's Residential Doing business as

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

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1790558286",
    "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": "888-977-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALTON RD STE 1",
            "city": "NEGAUNEE",
            "state": "MI",
            "postal_code": "498662002",
            "telephone_number": "906-451-4889",
            "fax_number": "906-228-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES RECOVERY CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT LAKES RECOVERY CENTERS, INC",
        "enumeration_date": "2023-11-06",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "GIUCHIN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "URIAS",
        "authorized_official_title_or_position": "SENIOR ACCOUNTANT",
        "authorized_official_telephone_number": "906-228-9699"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3272541",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teal Lake Women's Residential",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Teal Lake Women's Residential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Negaunee, 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.