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NPI Code Detail

MEDICARE: TELECARE CORPORATION GLADMAN MENTAL HEALTH REHABILITATION CENTER

MEDICARE: TELECARE CORPORATION GLADMAN MENTAL HEALTH REHABILITATION CENTER
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
1323P00000XPsychiatric Residential Treatment Facility02080009CA

General Provider Information

NPI Number : 1477751188
Entity Type Code : Organization
Provider Name (Legal Business Name) : TELECARE CORPORATION GLADMAN MENTAL HEALTH REHABILITATION CENTER
Provider Business Mailing Address
First Line : 2633 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-1912
Country : US
Telephone Number : 510-536-8111
Fax Number : 510-534-5202
Provider Business Practice Location Address
First Line : 2633 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-1912
Country : US
Telephone Number : 510-536-8111
Fax Number : 510-534-5202
Authorized Official
Title or Position : PROVIDER RELATIONS SUPERVISOR
Name : LORENA LOPEZ
Credential :
Telephone Number : 510-337-7950
Provider Enumeration Date : 07/03/2007
Last Update Date : 03/06/2023

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Directions to “TELECARE CORPORATION GLADMAN MENTAL HEALTH REHABILITATION CENTER ” Practice Location

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