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Organization
GREAT LAKES HEALTHCARE, INC.
Active
Organization
GREAT LAKES HEALTHCARE, INC.
Active
Other names
Preceptor Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
LEE JOHNSON (TREASURER)
(208) 401-1369
Entity
Organization
Contact information
Practice address
W175N11117 STONEWOOD DR STE 100, GERMANTOWN, WI 53022
(262) 293-3951
Mailing address
W175N11117 STONEWOOD DR STE 100, GERMANTOWN, WI 53022-6505
(262) 293-3951
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
05/09/2019
Last updated
08/11/2023
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