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General NPI Number Information
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NPI Number | 1932754033
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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 | 08/06/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 7821 ENGLISH HILLS RD
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City | VACAVILLE
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State | CA
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Zip | 95688-9543
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Country | US
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Telephone | 707-271-3604
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Fax | 707-927-1890
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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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