| Organization Name: | GREAT LAKES PERSONAL CARE SERVICES LLC |
| NPI Number: | 1295111227 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA COLEMAN CLEVELAND (PRESIDENT) |
| Mailing Address: | 2009 W Glen Park Ave Suite B Griffith |
| State: | IN US |
| Postal Code: | 463193735 |
| Phone Number: | 8779545727 |
| Fax Number: | 8669416921 |
| NPI Enumeration Date: | 07/31/2015 |
| NPI Last Update Date: | 08/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 140129981 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |