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GREAT LAKES RECOVERY CENTER LLC
NPI 1497376735
Substance Abuse Rehabilitation Facility in Fremont, OH

Active since April 28, 2020CLIA 36D2192337 · Waiver
2575 HAYES AVE, FREMONT, OH 43420(567) 280-9435 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 15, 2020, Jul 23, 2020 (2 updates tracked since 2020).

About Great Lakes Recovery Center Llc NPPES

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

GREAT LAKES RECOVERY CENTER LLC (NPI 1497376735) is a healthcare organization registered as a substance abuse rehabilitation facility in Fremont, Ohio and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through September 8, 2026 and lists David Guardiola, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1497376735
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameGREAT LAKES RECOVERY CENTER LLC
Location Address2575 HAYES AVEFremont, OH 43420-5201
Mailing Address441 N Broadway StGreen Springs, OH 44836-9689
Phone(567) 280-9435
Organization SubpartNo
Authorized OfficialDavid GuardiolaExecutive Director · (567) 280-9435
Enumeration DateApril 28, 2020
Last NPPES UpdateOctober 29, 20252 updates tracked since enumeration
NPPES CertifiedOctober 29, 2025
✔ NPI 1497376735 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.

2575 HAYES AVE, Fremont, OH 43420
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2192337

Great Lakes Recovery Center, LLC · Fremont, OH
Active · expires Sep 8, 2026
CLIA Number36D2192337
Laboratory TypeSud Iop
Certificate Effective DateSeptember 9, 2024
Certificate Expiration DateSeptember 8, 2026
Laboratory DirectorDavid Guardiola
Laboratory Phone(419) 680-0172
Laboratory LocationGreat Lakes Recovery Center, LLC2575 Hayes Avenue, Fremont, OH 43420
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN JOSEPH HIESTAND M.D.
Internal Medicine
2575 HAYES AVE, SUITE 1
FREMONT, OH 43420
Sandusky County (419) 332-1551
DR. HOWARD G. STIERWALT M.D.
Family Medicine
2575 HAYES AVE, SUITE 3
FREMONT, OH 43420
Sandusky County (419) 332-7371
JONATHAN F. DILLER, M.D., INC.
Family Medicine
2575 HAYES AVE, SUITE 4
FREMONT, OH 43420
Sandusky County (419) 332-9978
MARISSA KAY DINGLEDINE CDCA
Counselor (Addiction (Substance Use Disorder))
2575 HAYES AVE
FREMONT, OH 43420
Sandusky County (567) 280-9435
MERIDITH ELISE BRINKMAN LSW
Social Worker (Clinical)
2575 HAYES AVE
FREMONT, OH 43420
Sandusky County (567) 280-9435
JOHN LEE HOLBROOK
Counselor (Addiction (Substance Use Disorder))
2575 HAYES AVE
FREMONT, OH 43420
Sandusky County (567) 280-9435
CLARA PROEHL
Counselor (Addiction (Substance Use Disorder))
2575 HAYES AVE
FREMONT, OH 43420
Sandusky County (567) 280-9435
MANDI ELIZABETH JESTER MSW, LSW
Social Worker
2575 HAYES AVE
FREMONT, OH 43420
Sandusky County (567) 280-9435

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 Center LLC's NPI number?

The NPI number for Great Lakes Recovery Center LLC is 1497376735. It was assigned to this organization in the NPPES registry on April 28, 2020.

Where is Great Lakes Recovery Center LLC located?

Great Lakes Recovery Center LLC is located at 2575 Hayes Ave, Fremont, OH 43420. The listed phone number is (567) 280-9435.

What is Great Lakes Recovery Center LLC's specialty?

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

Does Great Lakes Recovery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2192337) is associated with this NPI, valid through September 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Great Lakes Recovery Center LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Molina Healthcare list Great Lakes Recovery Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Great Lakes Recovery Center LLC was last updated on October 29, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.