GREAT LAKES SENIOR HOMES INC. (NPI# 1104342112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104342112 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES SENIOR HOMES INC. |
| Practice Address |
6521 Red Maple Ln Bloomfield Hills MI 48301-3225 |
| Practice Telephone | 3132483401 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |
| Authorized Official Name | MELANIE DAVIS (OWNER) |
| Authorized Official Telephone | 2488183401 |
| Authorized Official Credential | LLBSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
6521 RED MAPLE LN |
| City | BLOOMFIELD HILLS |
| State | MI |
| Zip Code | 48301-3225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386278992 | Next Level Home Care | Home Health | 3595 W Maple Rd Ste 208, Bloomfield Hills, MI 48301 | 2020-02-24 |
| 1811352230 | Freda B. Lerman, Lpc, Psyd, Lp, Pllc | Psychologist | 6905 Telegraph Road Suite 100, Bloomfield Hills, MI 48301 | 2015-12-30 |
| 1790113223 | Kathy Biehl Kelly | Nurse Practitioner | 3355 Morningview Terrace, Bloomfield Hills, MI 48301 | 2013-10-18 |
| 1538406855 | Dynamic Home Health Care Agency | Case Management | 3744 Lincoln Drive, Bloomfield Hills, MI 48301 | 2013-01-07 |
| 1366798373 | A3 Medical | Family Medicine | 4050 Maple Road, Suite 101, Bloomfield Township, MI 48301 | 2012-07-27 |
| 1013299361 | Michael Kovel Samson | Internal Medicine | 4790 Apple Grove Court, Bloomfield Hills, MI 48301 | 2011-09-13 |
| 1376786152 | Pamela Ann Hibbard Timrek | Speech-Language Pathologist | 3816 Lincoln Drive, Bloomfield Township, MI 48301 | 2009-04-09 |
| 1164694584 | Alexandra Krot | Internal Medicine | 169 Bassett Place, Bloomfield Hills, MI 48301 | 2008-03-26 |
| 1619170644 | Latha T Kannan, Md, PC | Internal Medicine | 6715 Birmingham Club Drive, Bloomfield Hills, MI 48301 | 2007-06-07 |
| 1699802975 | Rebeca Urquiola | Dentist | 4220 Surrey Cross, Bloomfield Hills, MI 48301 | 2007-02-27 |
| Find all providers in zip 48301 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033660980 | Deborah Gutterson | Case Manager/Care Coordinator | 2747 Aldgate Dr, Bloomfield Hills, MI 48304-1701 | 2016-10-16 |
| 1871003673 | Valeria Diaz | Case Manager/Care Coordinator | 1410 S Telegraph Rd, Bloomfield Hills, MI 48302-0046 | 2017-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851670 | Kendall Brocavich | Case Manager/Care Coordinator | 397 Blunk St, Plymouth, MI 48170-3752 | 2020-11-04 |
| 1932700242 | Best Choice Health Services, LLC | Case Manager/Care Coordinator | 19300 Greenfield Rd Ste C, Detroit, MI 48235-2003 | 2020-11-03 |
| 1871193557 | Pierce Reynolds | Case Manager/Care Coordinator | 160 E Cambourne St, Ferndale, MI 48220-1310 | 2020-10-30 |
| 1588262331 | Emmarose Malone Dwyer | Case Manager/Care Coordinator | 3843 Thomas Rd, Oxford, MI 48371-1556 | 2020-10-14 |
| 1861090953 | Jordan Johnson | Case Manager/Care Coordinator | 19710 Cherry Hill St, Southfield, MI 48076-1061 | 2020-10-12 |
| 1871191957 | Katrina M Dicesare | Case Manager/Care Coordinator | 39340 Medallion Ct Apt 7103, Farmington Hills, MI 48331-4913 | 2020-10-12 |
| 1144837618 | Lisa Glover | Case Manager/Care Coordinator | 1977 Radcliff Ave Se, Grand Rapids, MI 49506-5140 | 2020-09-28 |
| 1891301347 | Cierra C Coward | Case Manager/Care Coordinator | 20752 Camden Sq Apt 205, Southfield, MI 48076-3824 | 2020-09-21 |
| 1245845791 | Amanda Evanoff | Case Manager/Care Coordinator | 4619 Jerome Rd, Clarkston, MI 48346-3735 | 2020-09-11 |
| 1326653122 | Malika Triplett | Case Manager/Care Coordinator | 3002 Meisner Ave, Flint, MI 48506-2434 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMFIELD HILLS |
| Zip Code | 48301 |
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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.