Glorious Eagles LLC

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

GLORIOUS EAGLES LLC

Practice address

2119 110TH LN NW
Coon Rapids, MN 55433-4173

Phone

(651) 263-6291

NPI assigned

Feb 21, 2025

Organization subpart

No

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

Authorized official

Name

Samson Alayande

Title

President

Phone

(651) 263-6291

Specialties & licenses 1

Addresses

Other names 1

• Glorious Eagles LLC Doing business as

Tax ID family

Glorious Eagles LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Glorious Eagles LLC

  • Early Intervention Provider Agency
  • Coon Rapids, MN
  • NPI 1184338774
  NPD tax ID

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1134925951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 110TH LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334173",
            "telephone_number": "651-263-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 110TH LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334173",
            "telephone_number": "651-263-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORIOUS EAGLES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "ALAYANDE",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-263-6291"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glorious Eagles LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawn N Girtler, MS, BCBA
• Inga Marie Giske, PMHNP
• Matthew Todd Glaser
• Beth Ann Glasser
• Lisa Niemczyk Glogowski, C.R.N.A
• Glorious Eagles LLC
• Denijal Gluhic
• Elizabeth Godfrey
• Derek Goerke, M.D.
• Luke Goettlicher, LADC

• Foster Care Agency in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Foster Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.