NPI | 1720524010 |
---|---|
Doing Business As | TELECARE VISTA AOT |
Entity Type | Organization |
Authorized Contact | LORENA LOPEZ Provider Relations Supervisor 510-747-0552 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2017-01-11 |
Last Update Date | 2022-10-17 |