Provider Demographics
NPI:1548980550
Name:GLORY HOME CARE- INC
Entity type:Organization
Organization Name:GLORY HOME CARE- INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNITE
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVESTRE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:772-404-9039
Mailing Address - Street 1:741 NW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-1823
Mailing Address - Country:US
Mailing Address - Phone:305-376-1033
Mailing Address - Fax:
Practice Address - Street 1:741 NW 55TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-1823
Practice Address - Country:US
Practice Address - Phone:305-376-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health