# GRAND TRAVERSE AREA COMMUNITY LIVING CENTERS NON PROFIT HOUSING CORPOR

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

## Provider details

- **NPI number:** 1477965036
- **Authorized official:** SUSAN R ONAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (231) 932-9030

## Contact information

- **Practice address:** 935 BARLOW ST, TRAVERSE CITY, MI 49686-4250
- **Practice address phone:** (231) 932-9030
- **Practice address fax:** (231) 941-3421
- **Mailing address:** 935 BARLOW ST, TRAVERSE CITY, MI 49686-4250
- **Mailing address phone:** (231) 932-9030
- **Mailing address fax:** (231) 941-3421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253J00000X | Foster Care Agency | AL280006975 | MI | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | AL280006975 | MI | Yes |

## Other

- **Enumeration date:** 05/29/2014
- **Last updated:** 05/29/2014