Provider Demographics
NPI:1083267884
Name:TELESMART SERVICES
Entity Type:Organization
Organization Name:TELESMART SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MATHISEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-358-1708
Mailing Address - Street 1:341 HILL ST
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2337
Mailing Address - Country:US
Mailing Address - Phone:323-683-5931
Mailing Address - Fax:626-358-1708
Practice Address - Street 1:341 HILL ST
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2337
Practice Address - Country:US
Practice Address - Phone:626-358-1708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MJO HOPE FOUNDATION INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251S00000XAgenciesCommunity/Behavioral Health