Provider Demographics
NPI:1164796512
Name:GLCI
Entity Type:Organization
Organization Name:GLCI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLDENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-708-3772
Mailing Address - Street 1:3800 W FIKE RD
Mailing Address - Street 2:
Mailing Address - City:COLEMAN
Mailing Address - State:MI
Mailing Address - Zip Code:48618-8534
Mailing Address - Country:US
Mailing Address - Phone:989-465-6606
Mailing Address - Fax:877-465-6606
Practice Address - Street 1:3800 W FIKE RD
Practice Address - Street 2:
Practice Address - City:COLEMAN
Practice Address - State:MI
Practice Address - Zip Code:48618-8534
Practice Address - Country:US
Practice Address - Phone:989-465-6606
Practice Address - Fax:877-465-6606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health