Organization
GREAT LAKES RECOVERY MISSION, LLC
Active
Parent organization
GREAT LAKES RECOVERY MISSION, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT LAKES RECOVERY MISSION, LLC
Authorized official
JOSHUA BUKOFFSKY (CEO)
(586) 491-1057
Entity
Organization
Contact information
Practice address
110 N ELK ST, SANDUSKY, MI 48471-1105
(810) 487-4676
Mailing address
5099 W FARRAND RD, CLIO, MI 48420-8215
(586) 491-1057
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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