Organization Active NPI

Gloria Home Care Agency and Support Staffing Inc

  • Home Health Agency
  • Valdosta, GA
National Provider Identifier
1114228665
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
092-R-0566 Issued in GA
Legal business name
GLORIA HOME CARE AGENCY AND SUPPORT STAFFING INC
Practice address
428 Connell Rd
Valdosta, GA 31602-1481
Phone
(229) 249-7717
Fax
(229) 231-3030
NPI assigned
Nov 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Authorized official

Name
Gloria Jean Anderson
Title
Ceo
Phone
(229) 249-7717

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 092-R-0566 GA Primary
In Home Supportive Care Agency 253Z00000X 092-R-0566 GA

Addresses

Primary practice location

428 Connell Rd
Valdosta, GA 31602-1481

Mailing address

428 Connell Rd
Valdosta, GA 31602-1481
Phone (229) 249-7717

National Provider Directory

National Provider Directory

Locations

428 Connell Rd
Valdosta, GA 31602
Phone (229) 245-1281

NPI Registry JSON

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

{
    "created_epoch": "1289692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1114228665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 CONNELL RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021481",
            "telephone_number": "229-249-7717",
            "fax_number": "229-231-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 CONNELL RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021481",
            "telephone_number": "229-249-7717",
            "fax_number": "229-231-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORIA HOME CARE AGENCY AND SUPPORT STAFFING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-14",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-249-7717"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "092-R-0566",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "092-R-0566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.