Great Lakes Home Health Care , LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GREAT LAKES HOME HEALTH CARE , LLC

Practice address

28800 Ryan Rd
Suite 325
Warren, MI 48092-4272

Phone

(586) 558-2950

Fax

(586) 620-6019

NPI assigned

Jun 26, 2007

Last updated

Jul 30, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bernadette Manuel, R.N.B.S.N

Title

Owner - Ceo

Phone

(586) 558-2950

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timiko Lei Drew, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Southfield, MI
  • NPI 1326471764
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1578769527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 325",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924272",
            "telephone_number": "586-558-2950",
            "fax_number": "586-620-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 325",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924272",
            "telephone_number": "586-558-2950",
            "fax_number": "586-620-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES HOME HEALTH CARE , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "OWNER - CEO",
        "authorized_official_telephone_number": "586-558-2950",
        "authorized_official_credential": "R.N.B.S.N"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NGS",
            "identifier": "237738",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelena Alexis Grant
• Renee Graves
• Jessica Gray
• Derek Grayson, M.D.
• Great Lakes Family Dental Group-Warren, P.C.
• Great Lakes Home Medical Equipment, Inc.
• Great Lakes Medical Center PC
• Great Lakes Medical Pharmacy LLC (All American Medical Pharmacy)
• Great Lakes Medical Supply LLC (BrightSky)
• Great Lakes MRI of Michigan LLC

• Home Health Agency in Warren, MI
• Providers in Warren, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.