GREAT LAKES HEALTHCARE, INC. (NPI# 1619532132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619532132 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES HEALTHCARE, INC. |
| Other Organization Name | PRECEPTOR HOSPICE |
| 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 | 251G00000X | Hospice Care, Community Based | Agencies |
| Other Name | Type Code |
|---|---|
| Preceptor Hospice | 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 |
| 1255996740 | Great Lakes Healthcare, Inc. | Home Health | 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 |
| 1255996740 | Great Lakes Healthcare, Inc. | Home Health | 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 | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992076608 | Serenity Hospice Care, LLC | Hospice Care, Community Based | W175n11117 Stonewood Dr, Suite 100, Germantown, WI 53022-6508 | 2012-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992317762 | Castle Senior Living, Inc | Hospice Care, Community Based | 13050 W Cleveland Ave, New Berlin, WI 53151-4013 | 2020-08-21 |
| 1982215307 | Moments Hospice of Appleton LLC | Hospice Care, Community Based | 806 Valley Rd Ste 1, Menasha, WI 54952-1120 | 2020-08-10 |
| 1992316319 | Moments Hospice of Madison LLC | Hospice Care, Community Based | 5315 Wall St Ste 135, Madison, WI 53718-7963 | 2020-08-10 |
| 1912531997 | Moments Hospice of Milwaukee | Hospice Care, Community Based | 1139 S Sunnyslope Dr Ste 200, Mt Pleasant, WI 53406-3998 | 2020-02-27 |
| 1194375915 | Moments Hospice of Eau Claire LLC | Hospice Care, Community Based | 2263 East Ridge Center, Eau Claire, WI 54701 | 2019-09-13 |
| 1871052944 | Kenya Pratt | Hospice Care, Community Based | 5510 N 33rd St, Milwaukee, WI 53209-4834 | 2019-03-18 |
| 1518432749 | Brighton Hospice Wisconsin | Hospice Care, Community Based | 300 N Executive Dr Ste 110, Brookfield, WI 53005-6016 | 2018-10-03 |
| 1184136939 | Legacy Hospice Cares LLC | Hospice Care, Community Based | 850 Elm Grove Rd Ste 21, Elm Grove, WI 53122-2527 | 2017-11-02 |
| 1720523210 | Holistic Hospice Inc | Hospice Care, Community Based | 3422 W Howard Ave, Greenfield, WI 53221-1208 | 2016-12-20 |
| 1740722586 | Bani Inc | Hospice Care, Community Based | 7434 N Lannon Rd, Lannon, Lannon, WI 53046-9746 | 2016-11-10 |
| Find all providers with the same taxonomy | ||||
| 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.