# GLOCKSTON LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Auburn Ravine Terrace
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568183788
- **Authorized official:** MR. DAN BUSHNELL (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (949) 508-8370

## Contact information

- **Practice address:** 750 AUBURN RAVINE RD, AUBURN, CA 95603-3820
- **Practice address phone:** (530) 823-6131
- **Mailing address:** 2266 LAVA RIDGE CT, ROSEVILLE, CA 95661-2856
- **Mailing address phone:** (949) 508-8370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/06/2022
- **Last updated:** 09/06/2022