Provider Demographics
NPI:1073790531
Name:GLORIOUS DAYS PERSONAL CARE HOME INC.
Entity Type:Organization
Organization Name:GLORIOUS DAYS PERSONAL CARE HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR713
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:713-674-1168
Mailing Address - Street 1:1706 GELLHORN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-3347
Mailing Address - Country:US
Mailing Address - Phone:713-674-1168
Mailing Address - Fax:713-674-1168
Practice Address - Street 1:1706 GELLHORN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-3347
Practice Address - Country:US
Practice Address - Phone:713-674-1168
Practice Address - Fax:713-674-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness