WALLOON LAKE RECOVERY LODGE LLC NPI 1861898918

NPI Information

NPI: 1861898918
Provider Name: WALLOON LAKE RECOVERY LODGE, LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
2594 SPRINGVALE RD
BOYNE FALLS, MI
ZIP 49713
Phone: (231) 535-2415
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WALLOON LAKE RECOVERY LODGE, LLC is a substance abuse rehabilitation facility in Boyne Falls, MI. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. WALLOON LAKE RECOVERY LODGE, LLC NPI is 1861898918. The provider is registered as an organization entity type.

The provider's business location address is:

2594 SPRINGVALE RD
BOYNE FALLS, MI
ZIP 49713
Phone: (231) 535-2415

The provider's authorized official is Martin J Gitre .
The authorized official title is Member and has the following contact phone number (248) 763-0863.

The enumeration date for this NPI number is 11/17/2014 and was last updated on 11/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		L183579	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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