Healthcare Provider Details

I. General information

NPI: 1790614394
Provider Name (Legal Business Name): HEART OF GLORIA CLINICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 PLEASANT ST STE 104
WEST DES MOINES IA
50266-5494
US

IV. Provider business mailing address

4949 PLEASANT ST STE 104
WEST DES MOINES IA
50266-5494
US

V. Phone/Fax

Practice location:
  • Phone: 832-582-4827
  • Fax:
Mailing address:
  • Phone: 832-582-4827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MISS DAREISHA TAYLOR
Title or Position: OWNER/THERAPIST
Credential: LISW
Phone: 832-582-4827