Organization
GREATER LAKES BEHAVIORAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSHANDA GRAYSON-THOMAS APRN PMHNP (MANAGER)
(219) 706-3898
Entity
Organization
Contact information
Practice address
3141 WILLOWCREEK RD UNIT L3, PORTAGE, IN 46368-4468
(219) 706-3898
(219) 706-3899
Mailing address
6212 US HIGHWAY 6 # 147, PORTAGE, IN 46368-5057
(219) 331-8063
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
03/20/2023
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