GREAT LAKES REGENERATIVE MEDICINE, PLLC (NPI# 1033758305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033758305 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES REGENERATIVE MEDICINE, PLLC |
| Practice Address |
2251 N Squirrel Rd Ste 206 Auburn Hills MI 48326-4602 |
| Mailing Address |
148 Golf Crest Dr Acworth GA 30101-5968 |
| Practice Telephone | 2488290385 |
| Mailing Telephone | 2488290239 |
| Mailing Fax Number | 6785745605 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | DR. ROBERT J BASAK (CLINIC DIRECTOR) |
| Authorized Official Telephone | 2488290385 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
2251 N SQUIRREL RD STE 206 |
| City | AUBURN HILLS |
| State | MI |
| Zip Code | 48326-4602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295256220 | Pdn Billing, LLC. | Home Health | 3165 Oxford West, Auburn Hills, MI 48326 | 2017-06-29 |
| 1326583238 | Doreen Lang | Contractor | 2384 E Walton Blvd, Auburn Hills, MI 48326 | 2016-12-31 |
| 1205282266 | Gomaa LLC | Pharmacy | 2191 South Blvd Ste 1b, Auburn Hills, MI 48326 | 2016-05-09 |
| 1346621430 | Georjeana Dillard-parker | Social Worker | 620 Sheffield Road, Auburn Hilla, MI 48326 | 2015-06-15 |
| 1205213188 | Alison Elizabeth Lindensmith | Social Worker | 2239 E Walton Blvd, Auburn Hills, MI 48326 | 2015-04-30 |
| 1679912141 | Deborah Lynn Mckeever | Registered Nurse | 165 S. Opdyke Rd., Lot 217, Auburn Hills, MI 48326 | 2013-06-18 |
| 1790033231 | Bridget Green | Counselor | 2387 Walton Blvd, Easter Seals, Auburn Hills, MI 48326 | 2012-08-15 |
| 1205106614 | Sally S. Barbat | Psychologist | 691 N Squirrel Rd Ste 115, Auburn Hills, MI 48326 | 2012-01-03 |
| 1124315403 | Emanuela A Popa | Pharmacist | 2564 N Squirrel Rd, Ap#162, Auburn Hills, MI 48326 | 2011-07-07 |
| 1679870737 | Oakland County Community Mental Health Authority | Community/Behavioral Health | 2011 Executive Hills Blvd, Auburn Hills, MI 48326 | 2011-02-24 |
| Find all providers in zip 48326 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659985042 | Passion and Purpose Pediatrics | Clinic/Center | 2944 Olden Oak Ln Apt 204, Auburn Hills, MI 48326-2177 | 2020-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730664 | Edward W. Sparrow Hospital Association | Clinic/Center | 2900 Hannah Blvd Ste 204, East Lansing, MI 48823-5382 | 2020-11-03 |
| 1952909558 | Quilted Rose Clinical Services, Pllc | Clinic/Center | 269 Walker St Ste 256, Detroit, MI 48207-4258 | 2020-10-15 |
| 1386250694 | A Better Me Therapy, LLC | Clinic/Center | 2503 S Linden Rd Ste 259, Flint, MI 48532-5462 | 2020-09-22 |
| 1275148165 | Anasthesia Pain Service PC | Clinic/Center | 15350 Michigan Ave, Dearborn, MI 48126 | 2020-09-09 |
| 1710597745 | Renew Child and Family Center | Clinic/Center | 383 Starkweather St, Plymouth, MI 48170-1382 | 2020-08-04 |
| 1467075358 | Shear Pointe Inc | Clinic/Center | 1971 E 14 Mile Rd, Birmingham, MI 48009-7244 | 2020-05-26 |
| 1992326466 | New Healthcare PC | Clinic/Center | 911 Dix St Ste B, Otsego, MI 49078-1609 | 2020-05-06 |
| 1851920581 | Emotional Wellness Group LLC | Clinic/Center | 11956 E Outer Dr, Detroit, MI 48224-2630 | 2020-04-04 |
| 1003445800 | Dr. Chris Popp, PC | Clinic/Center | 107 Aprill Dr Ste 5, Ann Arbor, MI 48103-1956 | 2020-04-03 |
| 1902431653 | Recovery Mobile Clinic | Clinic/Center | 3050 Steeple Road, White Lake, MI 48383 | 2020-03-03 |
| Find all providers with the same taxonomy | ||||
| City | AUBURN HILLS |
| Zip Code | 48326 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.