Provider Demographics
NPI:1396294039
Name:GREAT LAKES CARE PARTNERS INC
Entity type:Organization
Organization Name:GREAT LAKES CARE PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IFEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:UWECHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-637-8143
Mailing Address - Street 1:21880 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-4412
Mailing Address - Country:US
Mailing Address - Phone:248-471-9168
Mailing Address - Fax:
Practice Address - Street 1:21880 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-4412
Practice Address - Country:US
Practice Address - Phone:248-471-9168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health