Organization
GREAT LAKES ADULT DAY SERVICES, LLC
Active
Organization
GREAT LAKES ADULT DAY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYATTA LEGETTE RN (ADMINISTRATOR)
(313) 530-1161
Entity
Organization
Contact information
Practice address
19194 AUGUSTA CT, LIVONIA, MI 48152-4016
(313) 530-1161
Mailing address
19194 AUGUSTA CT, LIVONIA, MI 48152-4016
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
—
—
163WC2100X
Continence Care Registered Nurse
—
—
163WG0600X
Gerontology Registered Nurse
—
—
163WH1000X
Hospice Registered Nurse
Primary
4704275716
MI
163WN1003X
Nutrition Support Registered Nurse
—
—
163WP0000X
Pain Management Registered Nurse
—
—
163WW0000X
Wound Care Registered Nurse
11091605
WI
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
372500000X
Chore Provider
—
—
376K00000X
Nurse's Aide
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8278228
—
MI
Enumeration date
08/03/2017
Last updated
09/11/2025
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