GREAT LAKES ADULT DAY SERVICES, LLC (NPI# 1053835736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053835736 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES ADULT DAY SERVICES, LLC |
| Practice Address |
19194 Augusta Ct Livonia MI 48152-4016 |
| Practice Telephone | 3135301161 |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-08-03 |
| Authorized Official Name | KENYATTA LEGETTE (ADMINISTRATOR) |
| Authorized Official Telephone | 3135301161 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC1500X |
Registered Nurse Specialization: Community Health |
Nursing Service Providers | ||
| N | 163WC2100X |
Registered Nurse Specialization: Continence Care |
Nursing Service Providers | ||
| N | 163WG0600X |
Registered Nurse Specialization: Gerontology |
Nursing Service Providers | ||
| N | 163WH1000X |
Registered Nurse Specialization: Hospice |
4704275716 | MI | Nursing Service Providers |
| N | 163WN1003X |
Registered Nurse Specialization: Nutrition Support |
Nursing Service Providers | ||
| N | 163WP0000X |
Registered Nurse Specialization: Pain Management |
Nursing Service Providers | ||
| N | 163WW0000X |
Registered Nurse Specialization: Wound Care |
11091605 | WI | Nursing Service Providers |
| N | 251E00000X | Home Health | Agencies | ||
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| N | 372500000X | Chore Provider | Nursing Service Related Providers | ||
| N | 376K00000X | Nurse's Aide | Nursing Service Related Providers | ||
| N | 385H00000X | Respite Care | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 8278228 | 05 |
| Street Address |
19194 AUGUSTA CT |
| City | LIVONIA |
| State | MI |
| Zip Code | 48152-4016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648171 | Hillary Fitzsimmons Psyd Pllc | Clinic/Center | 19455 Weyhar St, Livonia, MI 48152 | 2020-10-30 |
| 1639780968 | Goyanka Ranganathan | Student in an Organized Health Care Education/Training Program | Ipc Primary Care Internal Medicine, 37595 Seven Mile Road, Suite 340, Livonia, MI 48152 | 2020-08-11 |
| 1457988552 | Adam Ouellette | Student in an Organized Health Care Education/Training Program | St. Joe's Outpatient Psychiatry and Counseling Center, 37595 Seven Mile Rd, Suite 230, Livonia, MI 48152 | 2020-03-26 |
| 1972006047 | Genise Kerner Md PC | Clinic/Center | 37675 Pembrooke Ave, Livonia, MI 48152 | 2018-03-14 |
| 1205340593 | Rafal Hamamh | Dentist | 37595 7 Mile Rd Ste 4450, Livonia, MI 48152 | 2017-11-22 |
| 1053830489 | Felicia Cerise Reese | Registered Nurse | 17197 N. Laurel Park Drive, 555, Livonia, MI 48152 | 2017-09-18 |
| 1164943882 | Muhammad Yasir | Student in an Organized Health Care Education/Training Program | 37595 Seven Mile Rd. #340, Livonia, MI 48152 | 2017-07-03 |
| 1184154544 | St Mary Mercy Physician Practices | Clinic/Center | 39201 7 Mile Rd Bldg Room140, Livonia, MI 48152 | 2017-06-18 |
| 1912437518 | Divonne Touch | Clinic/Center | 18298 Middlebelt, Liviona, MI 48152 | 2017-06-15 |
| 1861922445 | Cheryl Lang | Physical Therapist | 17177 N Laurel Park Drive, Suite 417, Livonia, MI 48152 | 2017-06-15 |
| Find all providers in zip 48152 | ||||
| Taxonomy Code | 163WC1500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787039 | Dawn Huff | Registered Nurse | 37771 7 Mile Rd, Livonia, MI 48152-1058 | 2018-10-28 |
| 1962645010 | Carrie Elizabeth Trubia | Registered Nurse | 20 Linden St, Livonia, NY 14487-9735 | 2009-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677869 | Linda Denise Harter | Registered Nurse | 7000 Eagle Rd, Davisburg, MI 48350-3200 | 2020-10-20 |
| 1396351458 | Nina Mattucci | Registered Nurse | 144 Rockway Dr, Linden, MI 48451-9140 | 2020-09-23 |
| 1679192124 | Edward Lawrence Demaagd | Registered Nurse | 4635 Lucas Dr Sw, Grandville, MI 49418-2293 | 2020-04-15 |
| 1255963161 | Ruth Hoogmoed | Registered Nurse | 6475 Bridlewood Ct Ne, Ada, MI 49301-9664 | 2020-02-08 |
| 1649815366 | Margaret Emily-pawlowski Bovee | Registered Nurse | 2444 Welsheimer Rd, Harbor Springs, MI 49740 | 2019-11-18 |
| 1356994099 | Wendy S Krause | Registered Nurse | 13266 Spence Rd, Three Rivers, MI 49093-9707 | 2019-07-22 |
| 1669037081 | Laura Esese | Registered Nurse | 3640 Brambleberry Dr Nw, Comstock Park, MI 49321-9796 | 2019-05-02 |
| 1306305925 | Paul J Klutts | Registered Nurse | 330 W Division St, Ishpeming, MI 49849-2340 | 2019-03-13 |
| 1598254344 | Jerri Dee Medved | Registered Nurse | 1327 Sherwood Forest Ct, Waterford, MI 48327-1677 | 2018-05-08 |
| 1255883450 | Sheila Andrews | Registered Nurse | 24110 Beverly St, Oak Park, MI 48237-1942 | 2016-11-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.