Grand Traverse Area Community Living Management Corporation

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

GRAND TRAVERSE AREA COMMUNITY LIVING MANAGEMENT CORPORATION

Doing business as

Brickways

Practice address

935 Barlow St
Traverse City, MI 49686-4250

Phone

(231) 932-9030

Fax

(231) 941-3421

NPI assigned

May 29, 2014

Organization subpart

No

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

Authorized official

Name

Susan R Onan

Title

Executive Director

Phone

(231) 932-9030

Specialties & licenses 3

Addresses

Other names 1

• Brickways Doing business as

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1851703417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 BARLOW ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864250",
            "telephone_number": "231-932-9030",
            "fax_number": "231-941-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 BARLOW ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864250",
            "telephone_number": "231-932-9030",
            "fax_number": "231-941-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TRAVERSE AREA COMMUNITY LIVING MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "ONAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "231-932-9030"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MI",
            "license": "6401007670",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MI",
            "license": "6401007670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brickways",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Kathleen Grace, RN
• Debra Kay Graetz, MD
• Tamara Graf, DIPL.AC. , DIPL. C.H
• Grand Traverse Allergy PC
• Grand Traverse Area Community Living Centers Non Profit Housing Corpor
• Grand Traverse Assessment and Therapy, PLLC
• Grand Traverse Children's Clinic
• Grand Traverse County Commission on Aging
• Grand Traverse County Health Department
• Grand Traverse County Health Department

• 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 Jan 26, 2017; 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.