Provider Demographics
NPI:1750463907
Name:TELECARE MENTAL HEALTH SERVICES OF TEXAS, INC.
Entity Type:Organization
Organization Name:TELECARE MENTAL HEALTH SERVICES OF TEXAS, INC.
Other - Org Name:SAN ANTONIO ACT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-337-7950
Mailing Address - Street 1:1080 MARINA VILLAGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6427
Mailing Address - Country:US
Mailing Address - Phone:510-337-7950
Mailing Address - Fax:510-337-7969
Practice Address - Street 1:2391 NE LOOP 410
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5600
Practice Address - Country:US
Practice Address - Phone:210-222-0152
Practice Address - Fax:210-222-1392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163459401Medicaid
TX163459401Medicaid
TX00195UMedicare PIN