# A GLORIOUS PLACE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043952880
- **Authorized official:** GLORY TATAW (CEO)
- **Authorized official phone:** (410) 696-2645

## Contact information

- **Practice address:** 3203A CORPORATE CT, ELLICOTT CITY, MD 21042-2247
- **Practice address phone:** (410) 205-2458
- **Mailing address:** 3203A CORPORATE CT, ELLICOTT CITY, MD 21042-2247
- **Mailing address phone:** (410) 696-2645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/12/2022
- **Last updated:** 02/21/2025