# GREAT LAKES HEALTHCARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Preceptor Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255996740
- **Authorized official:** LEE JOHNSON (TREASURER)
- **Authorized official phone:** (208) 401-1369

## Contact information

- **Practice address:** W175N11117 STONEWOOD DR STE 100, GERMANTOWN, WI 53022
- **Practice address phone:** (262) 293-3951
- **Mailing address:** W175N11117 STONEWOOD DR STE 100, GERMANTOWN, WI 53022-6505
- **Mailing address phone:** (262) 293-3951

## Taxonomy

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

## Other

- **Enumeration date:** 05/09/2019
- **Last updated:** 08/11/2023