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Organization

GREAT LAKES RECOVERY MISSION, LLC

Active
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Organization

GREAT LAKES RECOVERY MISSION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSHUA BUKOFFSKY (CEO)
(586) 491-1057
Entity
Organization

Contact information

Practice address
74 S ELK ST, SANDUSKY, MI 48471-1354
(810) 487-4676
(810) 496-4295
Mailing address
5099 W FARRAND RD, CLIO, MI 48420-8215
(810) 487-4676
(810) 496-4295

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—

Other

Enumeration date
02/03/2026
Last updated
02/03/2026
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