| Glom Outpatient Services Inc. | |
|
1111 W Tokay St Ste A Lodi CA 95240-3850 | |
| (925) 570-3282 | |
| Not Available |
| Full Name | Glom Outpatient Services Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1111 W Tokay St Ste A, Lodi, California |
| Authorized Official Name and Position | Allen Turner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9255703282 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glom Outpatient Services Inc. 3123 Independence Dr Livermore CA 94551-7595 Ph: (925) 999-4119 | Glom Outpatient Services Inc. 1111 W Tokay St Ste A Lodi CA 95240-3850 Ph: (925) 570-3282 |
| NPI Number | 1417537366 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417537366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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