Provider Demographics
NPI:1598919789
Name:MORNING GLORY HOME HEALTHCARE INC.
Entity Type:Organization
Organization Name:MORNING GLORY HOME HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALK
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:989-672-4121
Mailing Address - Street 1:4414 LEIX RD
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48744-9760
Mailing Address - Country:US
Mailing Address - Phone:989-672-4121
Mailing Address - Fax:
Practice Address - Street 1:4414 LEIX RD
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:MI
Practice Address - Zip Code:48744-9760
Practice Address - Country:US
Practice Address - Phone:989-672-4121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health