GREAT LAKES HEALTHCARE INC. NPI 1619532132

NPI Information

GREAT LAKES HEALTHCARE, INC. is a hospice care community based in Germantown, WI. GREAT LAKES HEALTHCARE, INC. NPI is 1619532132. The provider is registered as an organization entity type.
The provider Is Doing Business As Preceptor Hospice.

The provider's business location address is:

W175N11117 STONEWOOD DR STE 100
GERMANTOWN, WI
ZIP 53022
Phone: (262) 293-3951

The provider's authorized official is Lee Johnson .
The authorized official title is Treasurer and has the following contact phone number (208) 401-1369.

The CLIA number assigned to this NPI record is 52D2167908 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2019 and was last updated on 8/11/2023.

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:

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