Organization
TELECARE MENTAL HEALTH SERVICES OF OREGON, INC
Active
Other names
72nd Ave Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA LOPEZ (PROVIDER RELATIONS SUPERVISOR)
(510) 337-7950
Entity
Organization
Contact information
Practice address
7759 SE 72ND AVE, PORTLAND, OR 97206-7921
(503) 788-4500
(503) 788-4506
Mailing address
1080 MARINA VILLAGE PKWY STE 100, ALAMEDA, CA 94501-1078
(510) 337-7950
(510) 337-7969
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/19/2006
Last updated
05/17/2023
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