Gloryhouse Ilp
NPI #1093302291 in Baton Rouge, Louisiana
Provider Information
- NPI Number
- 1093302291
- Entity Type
- Organization
- Organization Name
- Gloryhouse Ilp
- Primary Specialty
- Clinic/Center - Community Health
- Enumeration Date
- Dec 22, 2020
- Last Updated
- Dec 22, 2020
Practice Location
- Address
- 3173 WASHINGTON AVE
- City
- Baton Rouge
- State
- Louisiana
- ZIP Code
- 70802-2178
- Phone
- (225) 778-7678
Authorized Official
- Name
- CYNTHIA JACKSON
- Title
- OWNER
- Phone
- (225) 614-8960
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Community Health — Community Health |
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