NPIMap

Organization Active NPI

Glom Substance Abuse Program

  • Substance Abuse Rehabilitation Facility
  • Galt, CA
National Provider Identifier
1558945337
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GLOM SUBSTANCE ABUSE PROGRAM
Practice address
13386 Marengo Rd
Galt, CA 95632-8429
Phone
(925) 570-3282
NPI assigned
May 8, 2021
Last updated
Mar 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Peggy PhelpsNPI 1730302795
Title
VP of Operations
Phone
(209) 412-2389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

13386 Marengo Rd
Galt, CA 95632-8429

Mailing address

3123 Independence Dr
Livermore, CA 94551-7595
Phone (925) 570-3282

Other practice location 1

2352 Expresso Ct
Stockton, CA 95210-6755
Phone (209) 412-2389

Other practice location 2

1922 Burney Falls Dr
Stockton, CA 95206-4506
Phone (209) 412-2389

Other practice location 3

6510 El Capitan Cir
Stockton, CA 95210-5103
Phone (209) 412-2389

Other practice location 4

8933 Blue Grass Dr
Stockton, CA 95210-4421
Phone (209) 412-2389

Other practice location 5

9087 Bridalveil Cir
Stockton, CA 95212-3107
Phone (209) 412-2389

Other practice location 6

2532 Etcheverry Dr
Stockton, CA 95212-3013
Phone (209) 412-2389

Other practice location 7

744 N Golden Gate Ave
Stockton, CA 95205-3921
Phone (209) 412-2389

Other practice location 8

10898 Boessow Rd
Galt, CA 95632-8451
Phone (925) 570-3282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240603002624 CA Part B Supplier - Clinic/Group Practice 1254873524 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Galt, CA; Stockton, CA; Merced, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Glom Substance Abuse Program10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773705600000",
    "number": "1558945337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 INDEPENDENCE DR",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945517595",
            "telephone_number": "925-570-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13386 MARENGO RD",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956328429",
            "telephone_number": "925-570-3282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2352 Expresso Ct",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952106755",
            "country_code": "US",
            "telephone_number": "209-412-2389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1922 Burney Falls Dr",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952064506",
            "country_code": "US",
            "telephone_number": "209-412-2389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6510 El Capitan Cir",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952105103",
            "country_code": "US",
            "telephone_number": "209-412-2389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8933 Blue Grass Dr",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952104421",
            "country_code": "US",
            "telephone_number": "209-412-2389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9087 Bridalveil Cir",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952123107",
            "country_code": "US",
            "telephone_number": "209-412-2389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2532 Etcheverry Dr",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952123013",
            "country_code": "US",
            "telephone_number": "209-412-2389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 N Golden Gate Ave",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952053921",
            "country_code": "US",
            "telephone_number": "209-412-2389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10898 Boessow Rd",
            "address_purpose": "LOCATION",
            "city": "Galt",
            "state": "CA",
            "postal_code": "956328451",
            "country_code": "US",
            "telephone_number": "925-570-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GLOM SUBSTANCE ABUSE PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-08",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "209-412-2389"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galt, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.