GREAT LAKES RECOVERY MISSION, LLC
NPI 1063171593
Substance Abuse Rehabilitation Facility in Flint, MI

Q: What is Great Lakes Recovery Mission, LLC's NPI number?

The NPI number for Great Lakes Recovery Mission, LLC is 1063171593. It was assigned to this organization in the NPPES registry on December 13, 2021.

Q: What is Great Lakes Recovery Mission, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Active since December 13, 2021

433 W 4TH AVE, FLINT, MI 48503(810) 275-2690 Get Directions Write a Review

NPPES record last updated: December 13, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Great Lakes Recovery Mission, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES RECOVERY MISSION, LLC (NPI 1063171593) is a healthcare organization registered as a substance abuse rehabilitation facility in Flint, Michigan and active in the NPI registry since December 2021. The organization lists Joshua Bukoffsky, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1063171593

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NameGREAT LAKES RECOVERY MISSION, LLC

Location Address433 W 4TH AVEFlint, MI 48503-2403

Mailing Address5099 W Farrand RdClio, MI 48420-8215 · (586) 491-1057

Phone(810) 275-2690

Organization SubpartYes

Authorized OfficialJoshua BukoffskyChief Executive Officer · (586) 491-1057

Enumeration DateDecember 13, 2021

NPPES CertifiedDecember 9, 2021

✔ NPI 1063171593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

Definition

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.

433 W 4TH AVE, Flint, MI 48503

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Recovery Mission, LLC's NPI number?

The NPI number for Great Lakes Recovery Mission, LLC is 1063171593. It was assigned to this organization in the NPPES registry on December 13, 2021.

Where is Great Lakes Recovery Mission, LLC located?

Great Lakes Recovery Mission, LLC is located at 433 W 4th Ave, Flint, MI 48503. The listed phone number is (810) 275-2690.

What is Great Lakes Recovery Mission, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Great Lakes Recovery Mission, LLC was last updated on December 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.