Provider Demographics
NPI:1013660810
Name:GLYD THERAPY
Entity Type:Organization
Organization Name:GLYD THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:ALBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-613-6559
Mailing Address - Street 1:27201 TOURNEY RD STE 201R
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1804
Mailing Address - Country:US
Mailing Address - Phone:949-613-6559
Mailing Address - Fax:
Practice Address - Street 1:27201 TOURNEY RD STE 201R
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-1804
Practice Address - Country:US
Practice Address - Phone:949-613-6559
Practice Address - Fax:949-606-9116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty