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General NPI Number Information
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NPI Number | 1790298347
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Entity Type | Organization
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Legal Business Name | TELECARE MENTAL HEALTH SERVICES OF WASHINGTON, INC
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 33480 13TH PL S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6357
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Country | US
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Telephone | 253-285-7101
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Fax | 253-874-7096
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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 | SVP, CFO
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Name | LESLIE DAVIS
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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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