Organization
THE GUARDIAN GLOW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLORY GODSON KOMBE (CEO)
(312) 385-9163
Entity
Organization
Contact information
Practice address
855 ROMAN RD, WAUKEE, IA 50263-8075
(312) 385-9163
Mailing address
855 ROMAN RD, WAUKEE, IA 50263-8075
(312) 385-9163
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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