| Telecare Agewise Icm | |
|
6160 Mission Gorge Rd Ste 108 San Diego CA 92120-3425 | |
| (619) 481-3850 | |
| (619) 481-3851 |
| Full Name | Telecare Agewise Icm |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6160 Mission Gorge Rd Ste 108, San Diego, California |
| Authorized Official Name and Position | Leslie Davis (SVP, CFO) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare Agewise Icm 1080 Marina Village Pkwy Ste 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | Telecare Agewise Icm 6160 Mission Gorge Rd Ste 108 San Diego CA 92120-3425 Ph: (619) 481-3850 |
| NPI Number | 1114447141 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 09/18/2020 |
| Certification Date | 09/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114447141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Aefct Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4669 Murphy Canyon Rd Ste 212, San Diego, CA 92123 Phone: 858-569-0056 Fax: 858-569-4233 | |
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Alba Community School Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4041 Oregon St, San Diego, CA 92104 Phone: 619-521-5720 | |
True Crew California Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8910 University Center Ln Ste 400, San Diego, CA 92122 Phone: 603-692-8173 | |
Adapt Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6070 Mission Gorge Rd, San Diego, CA 92120 Phone: 619-957-0888 | |
Wise Self Psychology, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2535 Kettner Blvd Ste 2b1, San Diego, CA 92101 Phone: 619-678-0020 |