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General NPI Number Information
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NPI Number | 1164796512
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Entity Type | Organization
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Legal Business Name | GLCI
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 3800 W FIKE RD
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City | COLEMAN
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State | MI
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Zip | 48618-8534
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Country | US
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Telephone | 989-465-6606
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Fax | 877-465-6606
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Provider Business Mailing Address
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Address Line | 3800 W FIKE RD
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City | COLEMAN
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State | MI
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Zip | 48618-8534
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Country | US
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Telephone | 989-465-6606
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Fax | 877-465-6606
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GENISE OLDENBURG
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Credential |
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Telephone | 989-708-3772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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