Gloryland Healthcare LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

GLORYLAND HEALTHCARE LLC

Practice address

17222 Merry Song CT
Richmond, TX 77407-2963

Phone

(513) 526-2468

NPI assigned

Sep 8, 2020

Organization subpart

No

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

Authorized official

Name

Benjamin Ezento

Title

Director

Phone

(513) 526-2468

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1497369425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17222 MERRY SONG CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774072963",
            "telephone_number": "513-526-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17222 MERRY SONG CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774072963",
            "telephone_number": "513-526-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORYLAND HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "EZENTO",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "513-526-2468"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Behavioral Disturbances) in Richmond, TX
• Providers in Richmond, TX by specialty
• Assisted Living Facility (Behavioral Disturbances) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.