# GLORIOUS HOME CARE ASSISTANCE LLC

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

## Provider details

- **NPI number:** 1255067310
- **Authorized official:** MINILVA AMUNGWA (PRESIDENT/CEO)
- **Authorized official phone:** (669) 295-8659

## Contact information

- **Practice address:** 111 N MARKET ST STE 300, SAN JOSE, CA 95113-1116
- **Practice address phone:** (669) 295-8659
- **Mailing address:** 1919 FRUITDALE AVE APT K768, SAN JOSE, CA 95128-4939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/29/2022
- **Last updated:** 07/29/2022