Provider Demographics
NPI:1073787982
Name:GLAMM CORP
Entity Type:Organization
Organization Name:GLAMM CORP
Other - Org Name:IN GOOD HANDS HOME ICF/DD-H
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZA MARIE
Authorized Official - Middle Name:GUTIERREZ
Authorized Official - Last Name:LUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-291-3528
Mailing Address - Street 1:380 BIXBY DR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6007
Mailing Address - Country:US
Mailing Address - Phone:408-263-1343
Mailing Address - Fax:
Practice Address - Street 1:380 BIXBY DR
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6007
Practice Address - Country:US
Practice Address - Phone:408-263-1343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLAMM CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-22
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities