Organization
GREAT LAKES HOME CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY-KIM EGERE (ADMINISTRATOR)
(763) 537-6651
Entity
Organization
Contact information
Practice address
6000 BASS LAKE RD STE 104, CRYSTAL, MN 55429-2753
(763) 537-6651
(763) 535-4288
Mailing address
6000 BASS LAKE RD STE 104, CRYSTAL, MN 55429-2753
(763) 537-6651
(763) 535-4288
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
353271
MN
253Z00000X
In Home Supportive Care Agency
353271
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
353271
CLASS A
MN
05
—
A697120000
—
MN
01
—
A838495100
PCPO
MN
Enumeration date
01/09/2012
Last updated
01/09/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us