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GREAT LAKES HOME CARE INC. NPI 1316217219


NPI Information

NPI: 1316217219
Provider Name: GREAT LAKES HOME CARE INC.
Classification: Nursing Care - 251J00000X
Entity Type: Organization
Address:
6000 BASS LAKE RD STE 104
CRYSTAL, MN
ZIP 55429
Phone: (763) 537-6651
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GREAT LAKES HOME CARE INC. is a nursing care in Crystal, MN. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. GREAT LAKES HOME CARE INC. NPI is 1316217219. The provider is registered as an organization entity type.

The provider's business location address is:

6000 BASS LAKE RD STE 104
CRYSTAL, MN
ZIP 55429-753
Phone: (763) 537-6651
Fax: (763) 535-4288

The provider's authorized official is Mary-kim Egere .
The authorized official title is Administrator and has the following contact phone number (763) 537-6651.

The enumeration date for this NPI number is 1/9/2012 and was last updated on 1/9/2012.


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
1253Z00000XIn Home Supportive Care353271MINNESOTANo
2251J00000XNursing Care353271MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A838495100OTHERMINNESOTAPCPO
2353271OTHERMINNESOTACLASS A
3A697120000MEDICAIDMINNESOTA

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: 5/5/2024

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