# GREAT LAKES SUPPORT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Lakes Support Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023238417
- **Authorized official:** MS. NICKIE LASHAWN GRAYS NONE (OWNER)
- **Authorized official phone:** (231) 932-8457

## Contact information

- **Practice address:** 800 S GARFIELD AVE STE B, TRAVERSE CITY, MI 49686-3486
- **Practice address phone:** (231) 932-8457
- **Practice address fax:** (231) 932-8457
- **Mailing address:** PO BOX 7153, TRAVERSE CITY, MI 49696-7153
- **Mailing address phone:** (231) 932-8457
- **Mailing address fax:** (231) 932-8457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | MI | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 09/06/2023