Provider Demographics
NPI:1962277137
Name:MCGLOTTEN ENTITIES, LLC
Entity type:Organization
Organization Name:MCGLOTTEN ENTITIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TYRALL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGLOTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-668-5140
Mailing Address - Street 1:251 E SHELDRAKE CIR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-5678
Mailing Address - Country:US
Mailing Address - Phone:302-668-5140
Mailing Address - Fax:
Practice Address - Street 1:251 E SHELDRAKE CIR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-5678
Practice Address - Country:US
Practice Address - Phone:302-668-5140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCGLOTTEN ENTITIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities