Provider Demographics
NPI:1104013911
Name:TO GOD BE THE GLORY ADULT DAY CARE
Entity Type:Organization
Organization Name:TO GOD BE THE GLORY ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWONNE
Authorized Official - Middle Name:ELEANORA
Authorized Official - Last Name:BOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-341-7701
Mailing Address - Street 1:9500 ARENA DR STE 102
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3703
Mailing Address - Country:US
Mailing Address - Phone:301-341-7701
Mailing Address - Fax:301-341-7734
Practice Address - Street 1:3601 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MD
Practice Address - Zip Code:20722-1300
Practice Address - Country:US
Practice Address - Phone:301-341-7701
Practice Address - Fax:301-341-7734
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TO GOD BE THE GLORY ADULT DAY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care