Gloryland Healthcare Services LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

GLORYLAND HEALTHCARE SERVICES LLC

Practice address

928 Long Manor Dr
Middle River, MD 21220-1700

Phone

(443) 882-5557

NPI assigned

Apr 16, 2020

Organization subpart

No

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

Authorized official

Name

Delphine E Ikpasaja

Title

Provider

Phone

(443) 882-5557

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1992325252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 LONG MANOR DR",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212201700",
            "telephone_number": "443-882-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 LONG MANOR DR",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212201700",
            "telephone_number": "443-882-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORYLAND HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "IKPASAJA",
        "authorized_official_first_name": "DELPHINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "443-882-5557"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Christine Fruhling, LCPC, LCADC
• Patrick Galloway, DPT
• Samantha Gard
• Pouya Gharahdaghi, MD
• Modupe Giwa
• Govindaraju Madhiraju M.D., P.a.
• Jamira Gray
• Keona Green, CPT
• Markiah Griffin
• Growing Smiles Orthodontics

• Multi-Specialty Clinic/Center in Middle River, MD
• Providers in Middle River, MD by specialty
• Multi-Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.