Provider Demographics
NPI:1619016995
Name:TELECARE SAN DIEGO REACH
Entity Type:Organization
Organization Name:TELECARE SAN DIEGO REACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERSONAL SERVICE COORDINATOR II
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-398-2181
Mailing Address - Street 1:446 26TH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-3026
Mailing Address - Country:US
Mailing Address - Phone:619-398-2181
Mailing Address - Fax:619-398-2171
Practice Address - Street 1:446 26TH ST FL 6
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-3026
Practice Address - Country:US
Practice Address - Phone:619-398-2181
Practice Address - Fax:619-398-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)