Organization
GLU FACTORY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVETTE PICKETT LMSW (DIRECTOR OF BUSINESS DEVELOPMENT)
(575) 935-4458
Entity
Organization
Contact information
Practice address
1200 N THORNTON ST, SUITE F, CLOVIS, NM 88101-5508
(575) 935-4458
Mailing address
1200 N THORNTON ST, SUITE F, CLOVIS, NM 88101-5508
(575) 935-4458
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6533578
—
NM
Enumeration date
06/29/2015
Last updated
06/30/2015
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