GREAT LAKES HEALTHCARE, INC. (NPI# 1255996740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255996740 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES HEALTHCARE, INC. |
| Other Organization Name | PRECEPTOR HOME HEALTH |
| Practice Address |
W175n11117 Stonewood Dr Ste 100 Germantown WI 53022 |
| Mailing Address |
W175n11117 Stonewood Dr Ste 100 Germantown WI 53022-6505 |
| Practice Telephone | 2622933951 |
| Mailing Telephone | 2622933951 |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-30 |
| Authorized Official Name | ELLIOT MCMILLAN (SECRETARY) |
| Authorized Official Telephone | 2084011359 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Other Name | Type Code |
|---|---|
| Preceptor Home Health | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1675 E Riverside Dr Ste 200, Eagle, ID 836167473 | 2084011369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184282618 | Great Lakes Healthcare, Inc. | Physical Therapist | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2019-05-30 |
| 1619532132 | Great Lakes Healthcare, Inc. | Hospice Care, Community Based | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022 | 2019-05-09 |
| 1225482557 | Great Lakes Healthcare, Inc. | Chiropractor | 3033 Marina Bay Dr, Suite 200, League City, TX 77573-3984 | 2016-04-23 |
| Street Address |
W175N11117 STONEWOOD DR STE 100 |
| City | GERMANTOWN |
| State | WI |
| Zip Code | 53022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609195239 | Easy Living Home Health Care Agency, Inc. | Home Health | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2010-05-21 |
| 1588297188 | Nicole Weggen | Occupational Therapist | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2020-02-21 |
| 1184282618 | Great Lakes Healthcare, Inc. | Physical Therapist | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2019-05-30 |
| 1619532132 | Great Lakes Healthcare, Inc. | Hospice Care, Community Based | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022 | 2019-05-09 |
| 1568953701 | Chantelle M Toth | Speech-Language Pathologist | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2018-05-23 |
| 1679080725 | Sarah Ann Geerts | Occupational Therapist | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2018-01-10 |
| 1205341294 | Lisa Jane Vanderzanden | Occupational Therapist | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2017-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831669407 | Margaret Jo Mulder | Chiropractor | W164 N11269 Squire Drive Suite B, Germantown, WI 53022 | 2018-11-27 |
| 1316441579 | Community Home Care Services | Home Health | N112 W16298 Mequon Rd, 127, Germantown, WI 53022 | 2018-03-22 |
| 1811426224 | Wi-care LLC | In Home Supportive Care | W175n11163 Stonewood Drive Ste 220, Germantown, WI 53022 | 2017-06-08 |
| 1134675358 | Kojo Bempong | Anesthesiologist Assistant | Ahcmg Anesthesiology, 4025 North 92nd Street, Wauwatosa, WI 53022 | 2016-08-28 |
| 1336501915 | Ashley Russell | Occupational Therapist | W175 N11117 Stonewood Drive, Suite 100, Germantown, WI 53022 | 2016-03-23 |
| 1134535735 | Erin Therese Grueneberg | Nurse Practitioner | W153 N9990 Neptune Drive, Germantown, WI 53022 | 2014-07-03 |
| 1306286836 | Kyle W Mcmahon | Occupational Therapist | W175 N1117 Stonewood Drive, Suite 100, Germantown, Wi, WI 53022 | 2013-06-28 |
| 1326354713 | Brittany Skogg | Physical Therapist | W175 W11117 Stonewood Dr., Suite 100, Germantown, WI 53022 | 2010-08-24 |
| 1669635066 | Joseph D Deguzman Dds Ms Sc | Clinic/Center | W172 N9723 Division Road, Suite A, Germantown, WI 53022 | 2008-07-07 |
| 1457513988 | Rustin A. West | Dentist | W172 N9723 Division Road Suite A, Germantown, WI 53022 | 2008-06-26 |
| Find all providers in zip 53022 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225653181 | Eternal Love LLC | Home Health | W175n11163 Stonewood Dr Ste 211, Germantown, WI 53022-6502 | 2020-06-16 |
| 1912541400 | Extended Care Services | Home Health | N112w16298 Mequon Rd # 142, Germantown, WI 53022-3306 | 2019-10-29 |
| 1568948206 | Heart To Heart Home Health Care | Home Health | 13705 Monarch Vista Dr, Germantown, MD 20874-2970 | 2018-07-16 |
| 1316441579 | Community Home Care Services | Home Health | N112 W16298 Mequon Rd, 127, Germantown, WI 53022 | 2018-03-22 |
| 1427412196 | Legacy Home Health Care & Hospice LLC | Home Health | W156n10952 Catskill Ln, Germantown, WI 53022-4215 | 2016-04-08 |
| 1689062309 | Oasis Care, LLC | Home Health | 19209 Liberty Mill Rd, Germantown, MD 20874-1419 | 2015-01-05 |
| 1881001105 | Niflo Services LLC | Home Health | 20358 Mill Pond Ter, Germantown, MD 20876-6034 | 2014-07-18 |
| 1720324767 | Jm First Care Health Services, Inc. | Home Health | 19933 Stoney Point Way, Germantown, MD 20876-5568 | 2012-12-19 |
| 1386996189 | Praise Home Health Services | Home Health | 19505 White Saddle Dr, Germantown, MD 20874-5015 | 2012-10-04 |
| 1609195239 | Easy Living Home Health Care Agency, Inc. | Home Health | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2010-05-21 |
| Find all providers in GERMANTOWN | ||||
| City | GERMANTOWN |
| Zip Code | 53022 |
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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.