Provider Demographics
NPI:1548422058
Name:TELECARE CORPORATION
Entity Type:Organization
Organization Name:TELECARE CORPORATION
Other - Org Name:SOLANO STRIDES
Other - Org Type:Other Name
Authorized Official - Title/Position:LVN
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EATMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-558-1600
Mailing Address - Street 1:1027 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-4511
Mailing Address - Country:US
Mailing Address - Phone:707-558-1600
Mailing Address - Fax:
Practice Address - Street 1:1027 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-4511
Practice Address - Country:US
Practice Address - Phone:707-558-1600
Practice Address - Fax:707-558-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23149251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
164X0000XOtherLVN