Organization
GREAT LAKES RECOVERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GUARDIOLA LISW-S (EXECUTIVE DIRECTOR)
(567) 280-9435
Entity
Organization
Contact information
Practice address
2575 HAYES AVE, FREMONT, OH 43420-5201
(567) 280-9435
Mailing address
441 N BROADWAY ST, GREEN SPRINGS, OH 44836-9689
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/28/2020
Last updated
10/29/2025
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