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General NPI Number Information
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NPI Number | 1003661042
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Entity Type | Organization
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Legal Business Name | GLORIOUS BUSINESS ENTERPRISE LLC
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 18204 GREENLAWN ST
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City | DETROIT
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State | MI
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Zip | 48221-2107
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Country | US
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Telephone | 313-802-0766
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Fax | 313-863-2563
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Provider Business Mailing Address
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Address Line | 29488 WOODWARD AVE # 326
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City | ROYAL OAK
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State | MI
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Zip | 48073-0903
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Country | US
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Telephone | 313-802-0766
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Fax | 313-863-2563
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Authorized Official
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Title or Position | OWNER
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Name | GLORIA CONYERS
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Credential | MBA
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Telephone | 313-802-0766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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