Organization
GREAT LAKE HOME CARE L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY DALE (OWNER)
(313) 537-5848
Entity
Organization
Contact information
Practice address
30800 TELEGRAPH RD STE 2815, BINGHAM FARMS, MI 48025-4544
(313) 537-5848
(248) 987-6919
Mailing address
17070 W 12 MILE RD, STE D, SOUTHFIELD, MI 48076-2116
(313) 537-5848
(248) 987-6919
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/18/2008
Last updated
05/18/2022
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