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Great Lakes Senior Care, Llc
Physical Disabilities Residential Treatment Facility in Portage, Indiana
NPI 1376828228

Great Lakes Senior Care, Llc is a Physical Disabilities Residential Treatment Facility based in Portage, IN. Great Lakes Senior Care, Llc practices in Portage, IN. The NPI Number for Great Lakes Senior Care, Llc is 1376828228 and holds a License No. 110126101 (Indiana).

The current practice location address for Great Lakes Senior Care, Llc is 6040 Lute Rd, Portage, IN and can be reached out via phone at 219-841-7559 and via fax at 219-763-4858.

Location: 6040 Lute Rd, Portage, IN, 46368-5008
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1376828228
Provider Name
Great Lakes Senior Care, Llc
Credential
Provider Entity Type
Organization
Address
6040 Lute Rd, Portage, IN, 46368-5008
Phone Number
219-841-7559
Fax Number
219-763-4858
Provider Enumeration Date
10/11/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2010300000 A 05 IN
institution
Provider Business Practice Location Address Details
Address
6040 Lute Rd
City
Portage
State
Indiana
Zip
46368-5008
Phone Number
219-841-7559
Fax Number
219-763-4858
person
Provider Business Mailing Address Details
Address
6040 Lute Rd
City
Portage
State
Indiana
Zip
46368-5008
Phone Number
219-841-7559
Fax Number
219-763-4858
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
License No.
110126101 (Indiana)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
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