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General NPI Number Information
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NPI Number | 1285368720
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Entity Type | Organization
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Legal Business Name | TELECARE CORPORATION
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 1775 WHITE LN
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City | STOCKTON
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State | CA
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Zip | 95215-1227
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Country | US
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Telephone | 209-921-6872
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Fax | 209-642-7045
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Provider Business Mailing Address
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Address Line | 1080 MARINA VILLAGE PKWY STE 100
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City | ALAMEDA
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State | CA
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Zip | 94501-1078
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Country | US
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Telephone | 510-337-7950
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Fax |
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Authorized Official
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Title or Position | SVP, CFO
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Name | MARSHALL LANGFELD
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Credential |
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Telephone | 510-337-7950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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