GREAT LAKES HOSPICE LLC NPI 1205433778

NPI Information

  • NPI: 1205433778
  • Provider Name: GREAT LAKES HOSPICE LLC
  • Classification: Hospice Care, Community Based - 251G00000X
  • Entity Type: Organization
  • CLIA Number: 52D2212848
  • Address: 5150 N PORT WASHINGTON RD STE 152
    GLENDALE, WI
    ZIP 53217
  • Phone: (262) 349-5753

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NPI Details

GREAT LAKES HOSPICE LLC is a hospice care community based in Glendale, WI. GREAT LAKES HOSPICE LLC NPI is 1205433778. The provider is registered as an organization entity type.

The provider's business location address is:

5150 N PORT WASHINGTON RD STE 152
GLENDALE, WI
ZIP 53217-453
Phone: (262) 349-5753

The provider's authorized official is Jeffrey Hoehn .
The authorized official title is Coo and has the following contact phone number (414) 962-5250.

The CLIA number assigned to this NPI record is 52D2212848 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/7/2020 and was last updated on 2/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251G00000XHospice Care, Community BasedYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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