| Telecare Early Intervention Recovery Services | |
|
4545 Georgetown Place Suite A3 Stockton CA 95207-6228 | |
| (510) 337-7950 | |
| (510) 337-7969 |
| Full Name | Telecare Early Intervention Recovery Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4545 Georgetown Place, Stockton, California |
| Authorized Official Name and Position | Lorena Lopez (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare Early Intervention Recovery Services 1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | Telecare Early Intervention Recovery Services 4545 Georgetown Place Suite A3 Stockton CA 95207-6228 Ph: (510) 337-7950 |
| NPI Number | 1982071502 |
|---|---|
| Provider Enumeration Date | 08/31/2015 |
| Last Update Date | 03/29/2023 |
| Certification Date | 03/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982071502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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