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General NPI Number Information
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NPI Number | 1447336508
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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 | 10/31/2006
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 2101 COURAGE DR
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City | FAIRFIELD
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State | CA
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Zip | 94533-6717
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Country | US
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Telephone | 707-784-2130
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Fax | 707-784-2139
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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 | 510-337-7969
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Authorized Official
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Title or Position | VICE PRESIDENT
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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 | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | DMH 2 016 026
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License Number State | CA
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