Organization Active NPI

Glory Group Home Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Durham, NC
National Provider Identifier
1609790435
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
GLORY GROUP HOME INC.
Practice address
5 Onyx CT
Durham, NC 27703-2680
Phone
(919) 408-4945
Fax
(984) 377-8660
NPI assigned
Aug 5, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Authorized official

Name
Jasmine Shavon Bethea, MSW,LCSW,LCASNPI 1184984510
Title
Owner
Phone
(919) 408-4945

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

5 Onyx CT
Durham, NC 27703-2680

Mailing address

5 Onyx CT
Durham, NC 27703-2680
Phone (919) 408-4945

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.

NPI Registry JSON

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

{
    "created_epoch": "1785888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1609790435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ONYX CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032680",
            "telephone_number": "919-408-4945",
            "fax_number": "984-377-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ONYX CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032680",
            "telephone_number": "919-408-4945",
            "fax_number": "984-377-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORY GROUP HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-05",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "BETHEA",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "SHAVON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-408-4945",
        "authorized_official_credential": "MSW,LCSW,LCAS"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.