Provider Demographics
NPI:1538859251
Name:GLO WITHIN SERVICES LLC
Entity type:Organization
Organization Name:GLO WITHIN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:GLENDALEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, ASW-G
Authorized Official - Phone:914-246-0324
Mailing Address - Street 1:2522 SOUTH RD # 1019
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5468
Mailing Address - Country:US
Mailing Address - Phone:917-513-8598
Mailing Address - Fax:914-840-1182
Practice Address - Street 1:5902 CHELSEA CV N
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-7110
Practice Address - Country:US
Practice Address - Phone:917-513-8598
Practice Address - Fax:914-840-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07454011Medicaid