{"npi":"1982960316","type":"NPI-2","status":"active","name":{"display":"Great Lakes Professional Services LLC","other":[],"organization_name":"GREAT LAKES PROFESSIONAL SERVICES LLC","authorised_official":"Ali Sobh"},"specialty":{"primary_taxonomy":"261QP2000X","primary_taxonomy_description":"Physical Therapy Clinic/Center","slug":"physical-therapy-clinic-center","schema_org_specialty":null,"all":[{"code":"261QP2000X","description":"Physical Therapy Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"22214 FORD RD","city":"DEARBORN HEIGHTS","state":"MI","postal_code":"481272420","country_code":"US","phone":"3135811623","fax":"3135814683"},{"purpose":"MAILING","street_1":"22214 FORD RD","city":"DEARBORN HEIGHTS","state":"MI","postal_code":"481272420","country_code":"US","phone":"3135811623","fax":"3135814683"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20150519000776","type_code":"12-65","type_desc":"PART B SUPPLIER - PHYSICAL/OCCUPATIONAL THERAPY GROUP IN PRIVATE PRACTICE","state":"MI","pac_id":"8426378217"}]},"enumeration_date":"2012-04-10","last_updated":"2021-03-03","_meta":{"source":"NPPES","snapshot_date":"2021-03-03","doc_url":"https://findmynpi.com/api"}}