# GRASS LAKE SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grass Lake Surgery Center LLC, Grass Lake Surgery Center LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790306991
- **Authorized official:** CLAIRE GIBSON (SR VPO)
- **Authorized official phone:** (214) 726-6042

## Contact information

- **Practice address:** 3800 CENTENNIAL BLVD, GRASS LAKE, MI 49240
- **Practice address phone:** (517) 701-3100
- **Mailing address:** 3800 CENTENNIAL DR, GRASS LAKE, MI 49240-8961
- **Mailing address phone:** (517) 701-3100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/29/2020
- **Last updated:** 05/06/2026