| 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 |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2022-10-17 |