| NPI | 1225039811 |
|---|---|
| Doing Business As | GREATER LAKES MENTAL HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | WILLIAM GLENN CZERWINSKI COO 253-620-5134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2022-01-07 |