Healthcare Provider Details

I. General information

NPI: 1205767613
Provider Name (Legal Business Name): AMERICAN GLORY HOME CARE LLC DBA WELLSERVE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 S 12TH ST STE 505
RICHMOND VA
23219-4053
US

IV. Provider business mailing address

11 S 12TH ST STE 505
RICHMOND VA
23219-4053
US

V. Phone/Fax

Practice location:
  • Phone: 267-423-2308
  • Fax: 215-754-1772
Mailing address:
  • Phone: 267-423-2308
  • Fax: 215-754-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SYED M ISLAM
Title or Position: CEO
Credential: NA
Phone: 267-423-2308