GRASS LAKE SURGERY CENTER LLC – NPI #1790306991
Clinic/Center

GRASS LAKE SURGERY CENTER LLC is an AHC clinic located in GRASS LAKE, MI. NPPES has assigned the NPI number 1790306991 to GRASS LAKE SURGERY CENTER LLC on April 29, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on May 06, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRASS LAKE SURGERY CENTER LLC below.

NPI Profile for
GRASS LAKE SURGERY CENTER LLC

NPI Number
1790306991
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRASS LAKE SURGERY CENTER LLC
Other name(s)
All associated names:
Doing Business As (dba)
Grass Lake Surgery Center LLC
Other Name
Grass Lake Surgery Center LLC
Primary location
3800 CENTENNIAL BLVD
GRASS LAKE, MI 49240
Phone: (517) 701-3100 Fax:
Mailing address
3800 CENTENNIAL DR
GRASS LAKE, MI 49240-8961
Phone: (517) 701-3100 Fax:
Organization Subpart
No
Authorized Official
CLAIRE GIBSON
SR VPO
Phone: (214) 726-6042
Updated
Certification Date
May 06, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.