NPIMap

Organization Active NPI

Gloryhouse Ilp

  • Community Health Clinic/Center
  • Baton Rouge, LA
National Provider Identifier
1093302291
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
GLORYHOUSE ILP
Practice address
3173 Washington Ave
Baton Rouge, LA 70802-2178
Phone
(225) 778-7678
Fax
(225) 341-6825
NPI assigned
Dec 22, 2020
Last updated
Dec 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cynthia JacksonNPI 1255734331
Title
Owner
Phone
(225) 614-8960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

3173 Washington Ave
Baton Rouge, LA 70802-2178

Mailing address

3173 Washington Ave
Baton Rouge, LA 70802-2178
Phone (225) 778-7678

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1093302291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173 WASHINGTON AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708022178",
            "telephone_number": "225-778-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3173 WASHINGTON AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708022178",
            "telephone_number": "225-778-7678",
            "fax_number": "225-341-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORYHOUSE ILP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-614-8960"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.