Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Walloon Lake Recovery Lodge, LLC

Substance Abuse Rehabilitation Facility in Boyne Falls, MI · enumerated 2014 · authorized official Jackie Wurst, Financial Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1750791505

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Walloon Lake Recovery Lodge, LLC

Other name <Unavail>

Practice address 2329 Center St, Boyne Falls, MI, 49713

Phone (231) 535-2822

Fax (231) 535-2372

Enumeration date May 2, 2014

Last updated in NPPES Mar 25, 2024

Taxonomy & classification

101Y00000X Counselor Behavioral Health & Social Service Providers Secondary

103T00000X Psychologist Behavioral Health & Social Service Providers Secondary

261QR0405X Substance Use Disorder Rehabilitation Clinic/Center Ambulatory Health Care Facilities Secondary

324500000X Substance Abuse Rehabilitation Facility Residential Treatment Facilities Primary

343900000X Non-emergency Medical Transport (VAN) Transportation Services Secondary

Authorized official

Name Jackie Wurst

Title Financial Director

Phone (231) 758-4566

Other identifiers

Identifier	Type	State	Issuer
SA0150024	Other	MI	LARA LICENSE
SA0690033	Other	MI	LARA LICENSE
SA0240041	Other	MI	LARA LICENSE
5801000334	Other	MI	TRANSPORTATION
SA0150031	Other	MI	LARA LICENSE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What type of organization is Walloon Lake Recovery Lodge, LLC?

Walloon Lake Recovery Lodge, LLC is registered in NPPES as a Substance Abuse Rehabilitation Facility (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-03-25.