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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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