Organization
GLOW BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLEIGH RIDER (FOUNDER)
(866) 559-4569
Entity
Organization
Contact information
Practice address
3712 ISLA VISTA CT, MADERA, CA 93637-3314
(559) 975-3299
Mailing address
8605 SANTA MONICA BLVD # 552856, WEST HOLLYWOOD, CA 90069-4109
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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