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General NPI Number Information
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NPI Number | 1871645549
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Entity Type | Organization
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Legal Business Name | GLORY TO GLORY MINISTRIES HOUSE OF REFUGE
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 615 LEWIS STREET SUITE 104
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City | OXFORD
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State | NC
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Zip | 27565
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Country | US
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Telephone | 919-690-8111
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Fax | 919-692-1113
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Provider Business Mailing Address
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Address Line | 1700 CARSON STREET
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City | RALEIGH
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State | NC
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Zip | 27608
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Country | US
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Telephone | 919-829-9491
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Fax | 919-832-3467
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS ANGELA THORPE FERRELL
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Credential |
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Telephone | 919-829-9491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 251B00000X
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License Number State | NC
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