Provider Demographics
NPI:1568033553
Name:GLORY CARE SERVICES, INC.
Entity type:Organization
Organization Name:GLORY CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MGBARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-206-1665
Mailing Address - Street 1:9353 W ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2989
Mailing Address - Country:US
Mailing Address - Phone:623-206-1665
Mailing Address - Fax:602-942-4993
Practice Address - Street 1:1849 W GREENWAY RD STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-3474
Practice Address - Country:US
Practice Address - Phone:623-251-8066
Practice Address - Fax:602-942-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services