Organization
GLOM SUBSTANCE ABUSE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY PHELPS (VP OF OPERATIONS)
(209) 412-2389
Entity
Organization
Contact information
Practice address
13386 MARENGO RD, GALT, CA 95632-8429
(925) 570-3282
Mailing address
3123 INDEPENDENCE DR, LIVERMORE, CA 94551-7595
(925) 570-3282
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/08/2021
Last updated
03/17/2026
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