Healthcare Provider Details

I. General information

NPI: 1417537366
Provider Name (Legal Business Name): GLOM OUTPATIENT SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W FLORA ST
STOCKTON CA
95202-1636
US

IV. Provider business mailing address

3123 INDEPENDENCE DR
LIVERMORE CA
94551-7595
US

V. Phone/Fax

Practice location:
  • Phone: 844-456-6677
  • Fax:
Mailing address:
  • Phone: 925-999-4119
  • Fax: 925-800-3102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLEN TURNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 925-570-3282