Provider Demographics
NPI:1568918969
Name:GLENN HOME UNLIMITED INC.
Entity Type:Organization
Organization Name:GLENN HOME UNLIMITED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-234-2910
Mailing Address - Street 1:103 HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-9028
Mailing Address - Country:US
Mailing Address - Phone:980-234-2910
Mailing Address - Fax:704-870-8865
Practice Address - Street 1:103 HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-9028
Practice Address - Country:US
Practice Address - Phone:980-234-2910
Practice Address - Fax:704-870-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL080030311ZA0620X
NCFCL080029311ZA0620X
NCFCL080028311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home