Organization
TELECARE MENTAL HEALTH SERVICES OF ARIZONA, INC
Active
Other names
TELECARE SIERRA VISTA ACT
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA LOPEZ (PROVIDER RELATIONS SUPERVISOR)
(510) 337-7950
Entity
Organization
Contact information
Practice address
75 N GARDEN AVE, SIERRA VISTA, AZ 85635-3805
(520) 459-9929
(520) 459-8152
Mailing address
1080 MARINA VILLAGE PARKWAY, SUITE 100, ALAMEDA, CA 94501-1078
(510) 337-7950
(510) 337-7969
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
OTC6995
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
987017
—
AZ
Enumeration date
10/28/2014
Last updated
03/23/2023
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