Provider Demographics
NPI:1083489298
Name:GLORIOUS HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:GLORIOUS HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:UMOREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-641-7971
Mailing Address - Street 1:7600 GEORGIA AVE NW STE 208
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1616
Mailing Address - Country:US
Mailing Address - Phone:202-641-7973
Mailing Address - Fax:
Practice Address - Street 1:7600 GEORGIA AVE NW STE 208
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1616
Practice Address - Country:US
Practice Address - Phone:202-641-7973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care