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Organization
GREAT LAKES SUPPORT SERVICES
Active
Organization
GREAT LAKES SUPPORT SERVICES
Active
Other names
Great Lakes Support Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICKIE LASHAWN GRAYS NONE (OWNER)
(231) 932-8457
Entity
Organization
Contact information
Practice address
800 S GARFIELD AVE STE B, TRAVERSE CITY, MI 49686-3486
(231) 932-8457
(231) 932-8457
Mailing address
PO BOX 7153, TRAVERSE CITY, MI 49696-7153
(231) 932-8457
(231) 932-8457
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MI
Other
Enumeration date
04/26/2007
Last updated
09/06/2023
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