Organization
TELECARE CORPORATION
Active
Other names
Telecare IMD Step-Down
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA LOPEZ (PROVIDER RELATIONS SUPERVISOR)
(510) 337-7950
Entity
Organization
Contact information
Practice address
4335 ATLANTIC AVE, LONG BEACH, CA 90807-2803
(562) 216-4900
(562) 484-3039
Mailing address
1080 MARINA VILLAGE PARKWAY, SUITE 100, ALAMEDA, CA 94501-1078
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
101191
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CR722A
MEDICARE PTAN
CA
Enumeration date
06/01/2012
Last updated
03/09/2023
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