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NPI Code Detail

MEDICARE: TELECARE MENTAL HEALTH SERVICES OF OREGON, INC

MEDICARE: TELECARE MENTAL HEALTH SERVICES OF OREGON, INC
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 : 1184318065
Entity Type Code : Organization
Provider Name (Legal Business Name) : TELECARE MENTAL HEALTH SERVICES OF OREGON, INC
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 : 14725 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-2556
Country : US
Telephone Number : 971-314-0144
Fax Number : 971-200-2073
Authorized Official
Title or Position : PROVIDER RELATIONS SUPERVISOR
Name : LORENA LOPEZ
Credential :
Telephone Number : 971-314-0144
Provider Enumeration Date : 06/05/2023
Last Update Date : 08/02/2023

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Directions to “TELECARE MENTAL HEALTH SERVICES OF OREGON, INC ” Practice Location

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