Provider Demographics
NPI:1366808628
Name:LATTER GLORY HOME CARE, INC.
Entity type:Organization
Organization Name:LATTER GLORY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETTA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-956-8101
Mailing Address - Street 1:3845 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-4123
Mailing Address - Country:US
Mailing Address - Phone:314-528-8560
Mailing Address - Fax:314-837-3007
Practice Address - Street 1:3845 WOODCREST DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-4123
Practice Address - Country:US
Practice Address - Phone:314-528-8560
Practice Address - Fax:314-837-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-01
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0017583Medicaid