Organization
GREATER LAKES MENTAL HEALTH FOUNDATION INC
Active
Other names
Greater Lakes Mental Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GLENN ROBERTSON (CEO)
(253) 403-1272
Entity
Organization
Contact information
Practice address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 581-7020
Mailing address
P.O. BOX 5299, MS: 820-5-PCO, TACOMA, WA 98415-0299
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043327
—
WA
Enumeration date
08/03/2005
Last updated
08/04/2025
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