Provider Demographics
NPI:1356145619
Name:GREAT LAKES LEARNING ACADEMY
Entity type:Organization
Organization Name:GREAT LAKES LEARNING ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-553-6986
Mailing Address - Street 1:2875 EYDE PKWY
Mailing Address - Street 2:#200
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823
Mailing Address - Country:US
Mailing Address - Phone:517-381-5062
Mailing Address - Fax:517-451-3025
Practice Address - Street 1:2875 EYDE PKWY
Practice Address - Street 2:#200
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-381-5062
Practice Address - Fax:517-451-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)