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General NPI Number Information
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NPI Number | 1992007793
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Entity Type | Organization
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Legal Business Name | GREAT LAKES WELLNESS & HOME HEALTH INC
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 20550 VERNIER RD
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City | HARPER WOODS
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State | MI
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Zip | 48225-1413
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Country | US
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Telephone | 586-871-2067
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Fax | 586-871-2113
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Provider Business Mailing Address
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Address Line | PO BOX 36391
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City | GROSSE POINTE
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State | MI
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Zip | 48236-0391
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Country | US
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Telephone | 313-740-5282
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. FRANCHELLA WASHINGTON
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Credential |
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Telephone | 586-510-0620
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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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