Provider Demographics
NPI:1275301996
Name:GLORY TO GLORY SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:GLORY TO GLORY SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-704-1092
Mailing Address - Street 1:9918 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7703
Mailing Address - Country:US
Mailing Address - Phone:813-704-1092
Mailing Address - Fax:
Practice Address - Street 1:9918 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7703
Practice Address - Country:US
Practice Address - Phone:813-704-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health