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
—
—
Other
Enumeration date
05/09/2019
Last updated
08/11/2023
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