NPI | 1538807706 |
---|---|
Doing Business As | TELECARE MAGNOLIA HOUSE |
Entity Type | Organization |
Authorized Contact | LORENA LOPEZ Provider Relations Supervisor 510-292-7024 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2022-05-26 |
Last Update Date | 2022-09-07 |