Organization
TELECARE CORPORATION
Active
Other names
Telecare-Adult Full Service Partnership
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DAVIS (SVP, CFO)
(510) 337-7950
Entity
Organization
Contact information
Practice address
1692 EL CAMINO REAL, SAN CARLOS, CA 94070-5208
(650) 817-9070
(650) 817-9074
Mailing address
1080 MARINA VILLAGE PKWY, 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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41BA
COUNTY MENTAL HEATLH CERTIFICATE
CA
01
—
CR722E
MEDICARE PTAN
CA
Enumeration date
12/04/2006
Last updated
07/14/2020
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