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Organization

GREAT LAKES ADDICTION RECOVERY SERVICES PLLC

Active
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Organization

GREAT LAKES ADDICTION RECOVERY SERVICES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBYN M JONES (BUSINESS MANAGER)
(517) 306-2244
Entity
Organization

Contact information

Practice address
142 E MAUMEE ST, ADRIAN, MI 49221-2735
(517) 306-2244
(866) 465-0269
Mailing address
142 E MAUMEE ST, ADRIAN, MI 49221-2735
(517) 306-2244
(866) 465-0269

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104719902
MI
Enumeration date
05/14/2020
Last updated
05/14/2020
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