Provider Demographics
NPI:1932988854
Name:GLOWING LANTERN HOME HEALTH
Entity Type:Organization
Organization Name:GLOWING LANTERN HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SIMES
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN
Authorized Official - Phone:919-935-3192
Mailing Address - Street 1:344 LUCKY RIBBON LN
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6158
Mailing Address - Country:US
Mailing Address - Phone:919-935-3192
Mailing Address - Fax:
Practice Address - Street 1:344 LUCKY RIBBON LN
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-6158
Practice Address - Country:US
Practice Address - Phone:919-935-3192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility