MEDICARE: GLORY HANDS HOME HEALTH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1790494227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLORY HANDS HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	7777 BONHOMME AVE STE 1838
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-1911
Country	:	US
Telephone Number	:	314-489-6777
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 BONHOMME AVE STE 1838
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-1911
Country	:	US
Telephone Number	:	314-489-6777
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	TAMARA DENISE TAYLOR
Credential	:
Telephone Number	:	314-489-6777

Provider Enumeration Date	:	11/23/2022
Last Update Date	:	11/23/2022

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