Provider Demographics
NPI:1467259606
Name:GLOVER, KIM (HHA)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:GLOVER
Suffix:
Gender:
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E 143RD ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3408
Mailing Address - Country:US
Mailing Address - Phone:404-707-5405
Mailing Address - Fax:
Practice Address - Street 1:960 E 143RD ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-3408
Practice Address - Country:US
Practice Address - Phone:404-707-5405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health