Provider Demographics
NPI:1275305286
Name:GLORIS HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:GLORIS HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWOUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-814-2938
Mailing Address - Street 1:3628 YENNAR LN APT 3A
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3288
Mailing Address - Country:US
Mailing Address - Phone:443-657-0997
Mailing Address - Fax:
Practice Address - Street 1:3628 YENNAR LN APT 3A
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-3288
Practice Address - Country:US
Practice Address - Phone:443-657-0997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care