Provider Demographics
NPI:1477813343
Name:GLORY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:GLORY HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHONAIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-667-8842
Mailing Address - Street 1:3103 BARKERS WOOD LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2298
Mailing Address - Country:US
Mailing Address - Phone:832-667-8842
Mailing Address - Fax:832-667-8842
Practice Address - Street 1:3103 BARKERS WOOD LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2298
Practice Address - Country:US
Practice Address - Phone:832-667-8842
Practice Address - Fax:832-667-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health