| Gloryhouse Ilp | |
|
3173 Washington Ave Baton Rouge LA 70802-2178 | |
| (225) 778-7678 | |
| (225) 341-6825 |
| Full Name | Gloryhouse Ilp |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 3173 Washington Ave, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Cynthia Jackson (OWNER) |
| Authorized Official Contact | 2256148960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gloryhouse Ilp 3173 Washington Ave Baton Rouge LA 70802-2178 Ph: (225) 778-7678 | Gloryhouse Ilp 3173 Washington Ave Baton Rouge LA 70802-2178 Ph: (225) 778-7678 |
| NPI Number | 1093302291 |
|---|---|
| Provider Enumeration Date | 12/22/2020 |
| Last Update Date | 12/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093302291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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