Organization Name: | GREAT LAKES HOME HEALTH SERVICES, INC. |
NPI Number: | 1568440055 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM DEARY (CEO) |
Mailing Address: | 900 Cooper Street Jackson |
State: | MI US |
Postal Code: | 492023398 |
Phone Number: | 5177809500 |
Fax Number: | 5177809700 |
NPI Enumeration Date: | 01/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 383512 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |