# GREAT LAKES HOME HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346816501
- **Authorized official:** MAXIM STESEL (MANAGER)
- **Authorized official phone:** (773) 819-2190

## Contact information

- **Practice address:** 2115 E WOODSTOCK PL, MILWAUKEE, WI 53202-1342
- **Practice address phone:** (773) 825-3336
- **Mailing address:** 8170 MCCORMICK BLVD STE 112, SKOKIE, IL 60076-2914
- **Mailing address phone:** (177) 381-9219

## Taxonomy

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

## Other

- **Enumeration date:** 05/28/2021
- **Last updated:** 05/28/2021