Organization
GLORIOUS HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUILINE OWITI (MEDICAID LIAISON)
(609) 403-8366
Entity
Organization
Contact information
Practice address
1703 LAWRENCEVILLE RD APT 3, LAWRENCE, NJ 08648-2951
(609) 403-8366
Mailing address
1703 LAWRENCEVILLE RD APT 3, LAWRENCE, NJ 08648-2951
(609) 403-8366
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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