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GREAT LAKES DIALYSIS, L.L.C.
NPI 1720095417
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Detroit, MI

Active since August 02, 2006CLIA 23D2314754 · Waiver
1/5
Overall Rating
14614 KERCHEVAL ST, DETROIT, MI 48215(313) 308-4200(313) 332-0334 Get Directions Write a Review

NPPES record last updated: April 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 7, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Great Lakes Dialysis, L.l.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES DIALYSIS, L.L.C. (NPI 1720095417), doing business as Dialysis Care Center Great Lakes East, is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Detroit, Michigan and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through November 25, 2026 and lists Morufu Olatunji Alausa, Authorized Official / Cmo, as its authorized official.

NPPES Registry Identity

NPI1720095417
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameGREAT LAKES DIALYSIS, L.L.C.
Location Address14614 KERCHEVAL STDetroit, MI 48215-2814
Mailing AddressPo Box 428Lockport, IL 60441-6428 · (815) 714-7170 · Fax (630) 672-4980
Phone(313) 308-4200
Fax(313) 332-0334
Organization SubpartNo
Authorized OfficialMorufu Olatunji AlausaAuthorized Official / Cmo · (815) 741-6830
Enumeration DateAugust 2, 2006
Last NPPES UpdateApril 7, 20252 updates tracked since enumeration
NPPES CertifiedApril 7, 2025
✔ NPI 1720095417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
License✔ Licensed in MI · 4301072901
14614 KERCHEVAL ST, Detroit, MI 48215
Open in Google Maps ↗

Other Names 1

Doing Business AsDialysis Care Center Great Lakes East

Other Identifiers 1

Other23D1011980MI · Clia#

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2314754

Great Lakes Dialysis, LLC Dba Dialysis Care Center Great Lakes East · Detroit, MI
Active · expires Nov 25, 2026
CLIA Number23D2314754
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateNovember 26, 2024
Certificate Expiration DateNovember 25, 2026
Laboratory DirectorBoniface Tubie
Laboratory Phone(313) 308-4200
Laboratory LocationGreat Lakes Dialysis, LLC Dba Dialysis Care Center Great Lakes East14614 Kercheval Avenue, Detroit, MI 48215
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for Great Lakes Dialysis, LLC (CMS certification number 232614), from CMS Care Compare.

Great Lakes Dialysis, LLC

Dialysis facility · Detroit, MI
1/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
CMS Certification Number232614
ESRD NetworkNetwork 11
Hemodialysis Stations24
Medicare-Certified SinceDecember 17, 2003
Location14614 KERCHEVAL STDetroit, MI 48215 · Wayne County
Phone(313) 308-4200
Services Offered
In-center hemodialysis Peritoneal dialysis Evening shifts (after 5 PM)

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALISA HAYGOOD
Specialist (Research Data Abstracter/Coder)
14614 KERCHEVAL ST
DETROIT, MI 48215
Wayne County (313) 308-4212

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Dialysis, L.L.C.'s NPI number?

The NPI number for Great Lakes Dialysis, L.L.C. is 1720095417. It was assigned to this organization in the NPPES registry on August 2, 2006. The provider is doing business as Dialysis Care Center Great Lakes East.

Where is Great Lakes Dialysis, L.L.C. located?

Great Lakes Dialysis, L.L.C. is located at 14614 Kercheval St, Detroit, MI 48215. The listed phone number is (313) 308-4200.

What is Great Lakes Dialysis, L.L.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Great Lakes Dialysis, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2314754) is associated with this NPI, valid through November 25, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Great Lakes Dialysis, L.L.C. a Medicare-certified dialysis facility?

Yes. Great Lakes Dialysis, LLC is a Medicare-certified dialysis facility, certified since December 17, 2003.

What quality rating does Great Lakes Dialysis, L.L.C. have?

CMS rates Great Lakes Dialysis, LLC 1 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Great Lakes Dialysis, L.L.C. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Great Lakes Dialysis, L.L.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Great Lakes Dialysis, L.L.C. was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.