OrganizationActive
Great Lakes Recovery Mission, LLC
NPI 1063171593 · Substance Abuse Rehabilitation Facility · Flint, MI
Provider details
- NPI number
- 1063171593
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Parent organization
- Great Lakes Recovery Mission, LLC
- Organization subpart
- Yes
- Authorized official
- Joshua Bukoffsky, Chief Executive Officer(586) 491-1057
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
433 W 4th Ave
Flint, MI 48503-2403
Phone: (810) 275-2690
Street-level locationGet directions
Mailing address
5099 W Farrand Rd
Clio, MI 48420-8215
Registry dates
- Enumerated
- 2021-12-13
- Last updated
- 2021-12-13
- Certified
- 2021-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.