Organization
TELECARE CORPORATION
Active
Other names
TELECARE LA ACT 4 OP
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DAVIS (SVP, CFO)
(510) 337-7950
Entity
Organization
Contact information
Practice address
3125 N BROADWAY, LOS ANGELES, CA 90031-2703
(213) 482-6400
(213) 482-6408
Mailing address
1080 MARINA VILLAGE PKWY, SUITE 100, ALAMEDA, CA 94501-6427
(510) 337-7950
(510) 337-7969
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7262
COUNTY MENTAL HEALTH CERTIFICATE
CA
Enumeration date
10/10/2006
Last updated
07/15/2020
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