Provider Demographics
NPI:1063526457
Name:GLORIOUS HOME HEALTH CARE INC.
Entity type:Organization
Organization Name:GLORIOUS HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OWOT
Authorized Official - Middle Name:E
Authorized Official - Last Name:OWOT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:214-607-4027
Mailing Address - Street 1:329 OAKS TRL STE 95
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-4092
Mailing Address - Country:US
Mailing Address - Phone:214-607-4027
Mailing Address - Fax:214-607-4028
Practice Address - Street 1:329 OAKS TRL STE 95
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-4092
Practice Address - Country:US
Practice Address - Phone:214-607-4027
Practice Address - Fax:214-607-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008853251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457808Medicare Oscar/Certification