# LAKE EFFECT RESTORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437907631
- **Authorized official:** ADAM PEPLINSKI (CFO)
- **Authorized official phone:** (231) 492-7974

## Contact information

- **Practice address:** 2493 MCDOUGAL RD, PETOSKEY, MI 49770-9597
- **Practice address phone:** (231) 883-4183
- **Mailing address:** 2493 MCDOUGAL RD, PETOSKEY, MI 49770-9597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 05/11/2024
- **Last updated:** 05/11/2024