GLORY VISITING PHYSICIAN PC. NPI 1669672705

NPI Information

NPI: 1669672705
Provider Name: GLORY VISITING PHYSICIAN PC.
Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
Entity Type: Organization
Address:
4245 S BEECH DALY ST
DEARBORN HTS, MI
ZIP 48125
Phone: (248) 569-5476
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GLORY VISITING PHYSICIAN PC. is a residential treatment facility physical disabilities in Dearborn Hts, MI. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. GLORY VISITING PHYSICIAN PC. NPI is 1669672705. The provider is registered as an organization entity type.

The provider's business location address is:

4245 S BEECH DALY ST
DEARBORN HTS, MI
ZIP 48125-567
Phone: (248) 569-5476
Fax: (248) 424-8987

The provider's authorized official is Charise Lanette Valentine .
The authorized official title is Neurologist and has the following contact phone number (248) 569-5476.

The enumeration date for this NPI number is 7/18/2007 and was last updated on 6/8/2015.

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	320700000X	Residential Treatment Facility, Physical Disabilities		4301053752	MICHIGAN	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	A16112	OTHER	MICHIGAN	UPIN

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: 5/5/2024

NPI Synchronization or Removal

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