Provider Demographics
NPI:1144785957
Name:GLORIFIED CARE SERVICES
Entity Type:Organization
Organization Name:GLORIFIED CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-574-4396
Mailing Address - Street 1:8423 TARAGLEN CT # NA
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2586
Mailing Address - Country:US
Mailing Address - Phone:832-574-4396
Mailing Address - Fax:
Practice Address - Street 1:8423 TARAGLEN CT # NA
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2586
Practice Address - Country:US
Practice Address - Phone:832-574-4396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home