Provider Demographics
NPI:1689173452
Name:GLORY HHC
Entity Type:Organization
Organization Name:GLORY HHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGNOLIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-699-4333
Mailing Address - Street 1:15255 S 94TH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3895
Mailing Address - Country:US
Mailing Address - Phone:224-699-4333
Mailing Address - Fax:219-802-8179
Practice Address - Street 1:15255 S 94TH AVE STE 500
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3895
Practice Address - Country:US
Practice Address - Phone:224-699-4333
Practice Address - Fax:219-802-8179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health