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NPI Code Detail

MEDICARE: TELECARE CORPORATION

MEDICARE: TELECARE CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320800000XMental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1013674068
Entity Type Code : Organization
Provider Name (Legal Business Name) : TELECARE CORPORATION
Provider Business Mailing Address
First Line : 1080 MARINA VILLAGE PKWY STE 100
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-1078
Country : US
Telephone Number : 510-337-7950
Fax Number : 510-337-7969
Provider Business Practice Location Address
First Line : 5400 KEARNY MESA RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-1303
Country : US
Telephone Number : 510-337-7950
Fax Number : 510-337-7969
Authorized Official
Title or Position : SVP, CFO
Name : LESLIE DAVIS
Credential :
Telephone Number : 510-337-7950
Provider Enumeration Date : 11/24/2021
Last Update Date : 11/24/2021

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Directions to “TELECARE CORPORATION ” Practice Location

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