Organization
GREAT LAKES COMPANIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY ROBERT FORD (PRESIDENT)
(810) 705-1017
Entity
Organization
Contact information
Practice address
15154 GOULD RD, ALLENTON, MI 48002-4206
(810) 705-1017
Mailing address
15154 GOULD RD, ALLENTON, MI 48002-4206
(810) 705-1017
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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