Great Lakes Adult Day Services, LLC
Registered Nurse, Hospice in Livonia, MI. Organization (NPI-2).
NPI number1053835736
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1053835736
- Entity type
- Organization (NPI-2)
- Legal business name
- Great Lakes Adult Day Services, LLC
- Organization subpart
- No
- Enumeration date
- Aug 3, 2017
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WH1000X | Registered Nurse, Hospice | 4704275716 | MI | Yes |
| 163WC1500X | Registered Nurse, Community Health | – | – | |
| 163WC2100X | Registered Nurse, Continence Care | – | – | |
| 163WG0600X | Registered Nurse, Gerontology | – | – | |
| 163WN1003X | Registered Nurse, Nutrition Support | – | – | |
| 163WP0000X | Registered Nurse, Pain Management | – | – | |
| 163WW0000X | Registered Nurse, Wound Care | 11091605 | WI | |
| 251E00000X | Home Health | – | – | |
| 251J00000X | Nursing Care | – | – | |
| 252Y00000X | Early Intervention Provider Agency | – | – | |
| 372500000X | Chore Provider | – | – | |
| 376K00000X | Nurse's Aide | – | – | |
| 385H00000X | Respite Care | – | – |
Practice location
19194 Augusta CtLivonia, MI 48152-4016
Phone 313-530-1161
Mailing address
19194 Augusta CtLivonia, MI 48152-4016
Authorized official
Kenyatta Legette
Administrator
3135301161
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