GLORY PERSONAL CARE HOME LLC NPI 1063712487

NPI Information

NPI: 1063712487
Provider Name: GLORY PERSONAL CARE HOME, LLC
Classification: Adult Companion - 372600000X
Entity Type: Organization
Address: 90 PACES LNDG
COVINGTON, GA
ZIP 30016
Phone: (678) 432-8818

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NPI Details

GLORY PERSONAL CARE HOME, LLC is an adult companion in Covington, GA. The provider is an individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. GLORY PERSONAL CARE HOME, LLC NPI is 1063712487. The provider is registered as an organization entity type.

The provider's business location address is:

90 PACES LNDG
COVINGTON, GA
ZIP 30016-167
Phone: (678) 432-8818

The provider's authorized official is Syvis A Rodgers .
The authorized official title is Director and has the following contact phone number (678) 342-8818.

The enumeration date for this NPI number is 11/1/2010 and was last updated on 11/1/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	385H00000X	Respite Care		RN 188675	GEORGIA	No
2	372600000X	Adult Companion		RN 188675	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RN188675	OTHER	GEORGIA	REGISTERED NURSE LICENSE
2	BLC10-17496	OTHER	GEORGIA	NEWTON COUNTY BUSINESS LICENSE
3	XXXX	OTHER	GEORGIA	GEORGIA DEPARTMENT OF COMMUNITY HEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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