Provider Demographics
NPI:1982033486
Name:TELECARE CORPORATION
Entity Type:Organization
Organization Name:TELECARE CORPORATION
Other - Org Name:CORDILLERAS MENTAL HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF RESIDENTIAL SUITES
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-367-1890
Mailing Address - Street 1:200 EDMONDS RD
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-3813
Mailing Address - Country:US
Mailing Address - Phone:650-367-1890
Mailing Address - Fax:
Practice Address - Street 1:200 EDMONDS RD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-3813
Practice Address - Country:US
Practice Address - Phone:650-367-1890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TELECARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness