NPI 1063171593

Great Lakes Recovery Mission, LLC

Organisation Substance Abuse Rehabilitation Facility Flint, MI

Practice location

Address: 433 W 4th Ave, Flint, MI 48503-2403
Phone: (810) 275-2690
Mailing address: 5099 W Farrand Rd, Clio, MI 48420-8215

Authorised official

Name: Joshua Bukoffsky
Title: Chief Executive Officer
Phone: (586) 491-1057

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Michigan →

Registry record

NPI: 1063171593
Entity type: Organization
NPI issued: 13 Dec 2021
Record last updated: 13 Dec 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.