Organization
TELECARE CORPORATION
Active
Other names
AMHS Telecare WIT FSP
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DAVIS (SVP, CFO)
(510) 337-7950
Entity
Organization
Contact information
Practice address
1910 N BUSH ST, SANTA ANA, CA 92706-2816
(714) 361-7950
(714) 361-7966
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
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CR722L
MEDICARE PTAN
CA
Enumeration date
06/20/2012
Last updated
05/04/2020
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