Provider Demographics
NPI:1831909571
Name:GLORIOUS HOMECARE LLC
Entity type:Organization
Organization Name:GLORIOUS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOMANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-955-8437
Mailing Address - Street 1:2925 WINNIPEG DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0448
Mailing Address - Country:US
Mailing Address - Phone:701-955-8437
Mailing Address - Fax:
Practice Address - Street 1:2925 WINNIPEG DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0448
Practice Address - Country:US
Practice Address - Phone:701-955-8437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging
No251E00000XAgenciesHome Health
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle