Organization
GREAT LAKE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IFRAH ELMI (CEO)
(763) 221-2102
Entity
Organization
Contact information
Practice address
1710 DOUGLAS DR N STE 224E, GOLDEN VALLEY, MN 55422-4350
(763) 221-2102
Mailing address
7549 EMERSON AVE N, BROOKLYN PARK, MN 55444-2539
(763) 221-2102
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6931842
—
MN
Enumeration date
08/05/2020
Last updated
08/05/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up