| Telecare Yuma Act | |
|
1595 S 1st Ave Yuma AZ 85364-4706 | |
| (928) 329-5855 | |
| (928) 329-5904 |
| Full Name | Telecare Yuma Act |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1595 S 1st Ave, Yuma, Arizona |
| 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 Yuma Act 1080 Marina Village Parkway Suite 100 Alameda CA 94501-1087 Ph: (510) 337-7950 | Telecare Yuma Act 1595 S 1st Ave Yuma AZ 85364-4706 Ph: (928) 329-5855 |
| NPI Number | 1043615412 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043615412 | NPI | - | NPPES |
| 986992 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | OTC6996 (Arizona) | Primary |
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