Provider Demographics
NPI:1942634670
Name:TELECARE CORP
Entity Type:Organization
Organization Name:TELECARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSC 1
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LESKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-447-9181
Mailing Address - Street 1:7592 HANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-6193
Mailing Address - Country:US
Mailing Address - Phone:760-447-9181
Mailing Address - Fax:
Practice Address - Street 1:55475 SANTA FE TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3117
Practice Address - Country:US
Practice Address - Phone:855-365-6558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health