NPI 1306650023
The Guardian Glow LLC
Practice location
- Address
- 855 Roman Rd, Waukee, IA 50263-8075
- Phone
- (312) 385-9163
Authorised official
- Name
- Glory Godson Kombe
- Title
- Ceo
- Phone
- (312) 385-9163
Registered specialties
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1306650023
- Entity type
- Organization
- NPI issued
- 4 Feb 2025
- Record last updated
- 4 Feb 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.