{
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"OrgName": "TELECARE MENTAL HEALTH SERVICES OF ARIZONA INC",
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"FirstLineMailingAddress": "1080 MARINA VILLAGE PARKWAY",
"SecondLineMailingAddress": "SUITE 100",
"MailingAddressCityName": "ALAMEDA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94501-1087",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-337-7950",
"MailingAddressFaxNumber": "510-337-7969",
"FirstLinePracticeLocationAddress": "1595 S 1ST AVE",
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"PracticeLocationAddressCityName": "YUMA",
"PracticeLocationAddressStateName": "AZ",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "928-329-5855",
"PracticeLocationAddressFaxNumber": "928-329-5904",
"EnumerationDate": "10/28/2014",
"LastUpdateDate": "03/23/2023",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOPEZ",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": "OTC6996",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}