Organization
TELECARE CORPORATION
Active
Other names
Deborah Coffman-Deasy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH MARY COFFMAN-DEASY (LPT)
19093889191
Entity
Organization
Contact information
Practice address
2080 S E ST, SAN BERNARDINO, CA 92408-2706
(909) 388-9191
Mailing address
2080 S E ST, SAN BERNARDINO, CA 92408-2706
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
33750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10
BEHAVIORAL HEALTH AND SOCIAL SERVICE PROVIDERS
CA
Enumeration date
05/30/2008
Last updated
06/09/2008
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