Organization
GREAT LAKES FOUNDATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN OF FOLLMER (DIRECTOR)
(602) 769-2142
Entity
Organization
Contact information
Practice address
65 N POTTEBAUM RD, CASA GRANDE, AZ 85122-5326
(602) 769-2142
Mailing address
65 N POTTEBAUM RD, CASA GRANDE, AZ 85122-5326
(602) 769-2142
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/09/2026
Last updated
05/09/2026
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