BEAR RIVER HEALTH – NPI #1750791505
Substance Abuse Rehabilitation Facility

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.

BEAR RIVER HEALTH is a substance abuse rehabilitation facility located in BOYNE FALLS, MI. NPPES has assigned the NPI number 1750791505 to BEAR RIVER HEALTH on May 02, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BEAR RIVER HEALTH” is a dba name, the actual legal business name for this organization is WALLOON LAKE RECOVERY LODGE, LLC. This provider is also associated with 2 additional names listed below. According to the NPI data, there are 8 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 2 years ago on Mar 25, 2024. 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 BEAR RIVER HEALTH below.

NPI Profile for
WALLOON LAKE RECOVERY LODGE, LLC

NPI Number
1750791505
Enumeration Date

(more than 12 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
WALLOON LAKE RECOVERY LODGE, LLC
Doing Business As (dba): BEAR RIVER HEALTH
Other name(s)
All associated names:
Doing Business As (dba)
BEAR RIVER HEALTH
Doing Business As (dba)
Bear River Outreach
Primary location
2329 CENTER ST
BOYNE FALLS, MI 49713-9268
Phone: (231) 535-2822 Fax: (231) 535-2372
8 Other location(s):
2594 Springvale Rd
Boyne Falls, MI 49713-9684
Phone: (231) 535-2822
218 Water St
Cheboygan, MI 49721-1606
Phone: (231) 751-0070
811 Sammons St
Cheboygan, MI 49721
Phone: (231) 535-2822
1619 West M32
gaylord, MI 49735
Phone: (231) 535-2822
8486 M 119
Harbor Springs, MI 49740-8508
Phone: (231) 545-4141
2480 W Campus Dr
MT Pleasant, MI 48858-5414
Phone: (231) 535-2822
906 E Bellows St
MT Pleasant, MI 48858-3940
Phone: (231) 535-2822
910 E Bellows St
MT Pleasant, MI 48858-3930
Phone: (231) 535-2822
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JACKIE WURST
FINANCIAL DIRECTOR
Phone: (231) 758-4566
Updated
Certification Date
Mar 25, 2024

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.

Identifiers

Identifiers for BEAR RIVER HEALTH

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
otherLARA LICENSEMISA0150024
otherLARA LICENSEMISA0240041
otherLARA LICENSEMISA0150031
otherLARA LICENSEMISA0690033
otherTRANSPORTATIONMI5801000334
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.

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.