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Organization

TELECARE SOAR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ARIANA KELLY GILLESPIE BA PSYCHOLOGY (CASE MANAGER)
(916) 484-3570
Entity
Organization

Contact information

Practice address
900 FULTON AVE STE 205, SACRAMENTO, CA 95825-4517
(916) 484-3570
Mailing address
900 FULTON AVE STE 205, SACRAMENTO, CA 95825-4517
(916) 484-3570

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
CA

Other

Enumeration date
04/04/2013
Last updated
04/04/2013
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