Organization
GLORY DAYS SUPPORT SERVICE, LLC
Active
Other names
Glory Days Transportation, LLC, Glory Days, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLA KAYCEO HENRY PETTY (CEO/OWNER)
(434) 688-4711
Entity
Organization
Contact information
Practice address
625 PINEY FOREST RD, SUITE 302C,, SAME, DANVILLE, VA 24540
(434) 421-2196
(434) 688-4713
Mailing address
625 PINEY FOREST RD, SUITE 302C,, SAME, DANVILLE, VA 24540
(434) 421-2196
(434) 688-4713
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T60227306
—
VA
Enumeration date
12/02/2019
Last updated
12/02/2019
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