GREAT LAKES SENIOR CARE, LLC (NPI# 1376828228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376828228 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES SENIOR CARE, LLC |
| Other Organization Name | HOME HELPERS |
| Practice Address |
6040 Lute Rd Portage IN 46368-5008 |
| Practice Telephone | 2198417559 |
| Practice Fax Number | 2197634858 |
| Mailing Telephone | 2198417559 |
| Mailing Fax Number | 2197634858 |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |
| Authorized Official Name | MR. JAMES R VANVLIET (MANAGING PARTNER) |
| Authorized Official Telephone | 2198417559 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | 110126101 | IN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 2010300000 A | 05 |
| Other Name | Type Code |
|---|---|
| Home Helpers | Doing Business As Name - Organization |
| Street Address |
6040 LUTE RD |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-5008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912952706 | Sleep Disorder Institute of Northwest Indiana LLC | Technician, Other | 6040 Lute Rd, Suite A, Portage, IN 46368-5008 | 2006-05-23 |
| 1801121496 | Zeenia Irani | Physical Therapist | 6040 Lute Rd, Portage, IN 46368-5008 | 2009-10-15 |
| 1134367188 | Chester K Pablo | Physical Therapist | 6040 Lute Rd, Portage, IN 46368-5008 | 2009-01-29 |
| 1477720274 | Ashleigh Louise Goetz | Occupational Therapy Assistant | 6040 Lute Rd, Portage, IN 46368-5008 | 2008-05-12 |
| 1871786350 | Ellen M Mccue | Occupational Therapist | 6040 Lute Rd, Portage, IN 46368-5008 | 2007-08-20 |
| 1568652170 | Rolando Alicea | Occupational Therapy Assistant | 6040 Lute Rd, Portage, IN 46368-5008 | 2007-07-30 |
| 1750571576 | Jill Armstrong | Physical Therapist | 6040 Lute Rd, Portage, IN 46368-5008 | 2007-07-27 |
| 1427248244 | Rick D Logan | Physical Therapist | 6040 Lute Rd, Portage, IN 46368-5008 | 2007-07-27 |
| 1275723009 | Patricia A Slamkowski | Physical Therapist | 6040 Lute Rd, Portage, IN 46368-5008 | 2007-07-27 |
| 1639369457 | Paula A Bisseker | Physical Therapist | 6040 Lute Rd, Portage, IN 46368-5008 | 2007-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194149757 | Collins Care Services | Residential Treatment Facility, Physical Disabilities | 4270 Burkhart West Dr, D, Indianapolis, IN 46227-1465 | 2014-02-18 |
| 1417123985 | Senior Care of Kokomo, LLC Dba Comfort Keepers #566 | Residential Treatment Facility, Physical Disabilities | 1511 W Sycamore St Ste A, Kokomo, IN 46901-4230 | 2008-05-05 |
| 1023199486 | Southern Indiana Center for Independent Living, Inc | Residential Treatment Facility, Physical Disabilities | 157 Teke Burton Dr, Mitchell, IN 47446-1208 | 2006-10-18 |
| 1467842039 | Melissa Goldstein | Residential Treatment Facility, Physical Disabilities | 8800 Spoon Dr, Indianapolis, IN 46219-4230 | 2015-02-03 |
| 1639569478 | Greenbriar Village, LLC | Residential Treatment Facility, Physical Disabilities | 8800 Spoon Dr, Indianapolis, IN 46219-4230 | 2015-02-02 |
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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.