Provider Demographics
NPI:1073176491
Name:GLORY HEALTH CARE AND IN HOME SERVICES
Entity Type:Organization
Organization Name:GLORY HEALTH CARE AND IN HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:ABERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-992-0048
Mailing Address - Street 1:85 SHEA LN
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-1261
Mailing Address - Country:US
Mailing Address - Phone:404-992-0048
Mailing Address - Fax:866-654-7302
Practice Address - Street 1:85 SHEA LN
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-1261
Practice Address - Country:US
Practice Address - Phone:404-992-0048
Practice Address - Fax:866-654-7302
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAAS INVESTMENTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health