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General NPI Number Information
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NPI Number | 1235808866
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Entity Type | Organization
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Legal Business Name | CROWN OF GLORY SENIOR HOMECARE COMPANY
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 542 JANEWAY DR APT 163
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City | NORRISTOWN
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State | PA
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Zip | 19401-3160
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Country | US
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Telephone | 267-888-6511
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1186
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City | NORRISTOWN
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State | PA
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Zip | 19404-1186
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Country | US
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Telephone | 267-888-6511
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOLANDA LUCAS
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Credential | LPN
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Telephone | 267-888-6511
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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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