| Telecare Imd Step-down | |
|
4335 Atlantic Ave Long Beach CA 90807-2803 | |
| (562) 216-4900 | |
| (562) 484-3039 |
| Full Name | Telecare Imd Step-down |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4335 Atlantic Ave, Long Beach, 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 Imd Step-down 1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 Ph: () - | Telecare Imd Step-down 4335 Atlantic Ave Long Beach CA 90807-2803 Ph: (562) 216-4900 |
| NPI Number | 1811258288 |
|---|---|
| Provider Enumeration Date | 06/01/2012 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811258288 | NPI | - | NPPES |
| CR722A | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 101191 (California) | Primary |
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