Provider Demographics
NPI:1033642715
Name:GREAT LAKES LIVING SOLUTIONS CORP.
Entity Type:Organization
Organization Name:GREAT LAKES LIVING SOLUTIONS CORP.
Other - Org Name:ALWAYS BEST CARE CHICAGOLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FRISCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-426-1356
Mailing Address - Street 1:477 E. BUTTERFIELD RD.
Mailing Address - Street 2:SUITE LL005
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148
Mailing Address - Country:US
Mailing Address - Phone:630-426-1099
Mailing Address - Fax:630-519-1310
Practice Address - Street 1:477 E. BUTTERFIELD RD.
Practice Address - Street 2:SUITE LL005
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:630-426-1099
Practice Address - Fax:630-519-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-09
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
IL3001497253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health