MEDICARE: TELEHEALTH MH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1144036831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELEHEALTH MH LLC

Provider Business Mailing Address
First Line	:	1464 E WHITESTONE BLVD STE 1304D
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-9072
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 PROSPERITY DR OFC 245
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4718
Country	:	US
Telephone Number	:	949-506-6162
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JACK BRENNAN
Credential	:
Telephone Number	:	949-264-5049

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	06/01/2026

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Directions to “TELEHEALTH MH LLC ” Practice Location

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