TELECARE MENTAL HEALTH SERVICES OF OREGON, INC (NPI# 1659453686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659453686 |
| Entity Type | Organization |
| Organization Name | TELECARE MENTAL HEALTH SERVICES OF OREGON, INC |
| Other Organization Name | 72ND AVE RECOVERY CENTER |
| Practice Address |
7759 Se 72nd Ave Portland OR 97206-7921 |
| Mailing Address |
1080 Marina Village Pkwy Ste 100 Alameda CA 94501-1078 |
| Practice Telephone | 5037884500 |
| Practice Fax Number | 5037884506 |
| Mailing Telephone | 5103377950 |
| Mailing Fax Number | 5103377969 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARSHALL LANGFELD (VICE PRESIDENT) |
| Authorized Official Telephone | 5103377950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| 72nd Ave Recovery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073601647 | Telecare Mental Health Services of Oregon, Inc | Psychiatric Residential Treatment Facility | 1605 E Lincoln Rd, Woodburn, OR 97071-5137 | 2006-10-10 |
| 1740378371 | Telecare Mental Health Services of Oregon, Inc | Community Based Residential Treatment Facility, Mental Illness | 4104 Ne Division St, Gresham, OR 97030-4618 | 2006-10-10 |
| 1245624253 | Telecare Mental Health Services of Oregon, Inc | Community Based Residential Treatment Facility, Mental Illness | 805 Se 151st Ave, Portland, OR 97233-2916 | 2015-03-27 |
| 1487853040 | Telecare Mental Health Services of Oregon, Inc | Community Based Residential Treatment Facility, Mental Illness | 1080 Marina Village Pkwy, Suite 100, Alameda, CA 94501-6427 | 2007-07-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | TELECARE MENTAL HEALTH SERVICES OF OREGON, INC. | 1080 Marina Village Parkway Ste 100, Alameda, CA 94501 |
| Street Address |
7759 SE 72ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97206-7921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326685934 | Adam Pettee | Specialist | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-12-02 |
| 1386285856 | Nahla Torres | Case Manager/Care Coordinator | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-10-04 |
| 1922656941 | Isatou Bojang | Case Manager/Care Coordinator | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-09-03 |
| 1457905663 | Hannah Elizabeth Lehmann | Case Manager/Care Coordinator | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-07-25 |
| 1467013326 | Erin Elizabeth Farr | Specialist | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-06-21 |
| 1083271290 | Pa Eddi Camara | Case Manager/Care Coordinator | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-05-22 |
| 1518429455 | Sandra Marie Groesbeck | Case Manager/Care Coordinator | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-04-01 |
| 1811458771 | Christopher Bruce Carstensen | Specialist | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-03-25 |
| 1639635998 | Elizabeth Rachele Freeman | Peer Specialist | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-02-12 |
| 1629542055 | Jan Clay | Counselor | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2019-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346852365 | Amanda Kristine Fredrickson | Dietitian, Registered | 3611 Se 64th Ave., Portland, OR 97206 | 2020-08-20 |
| 1578108940 | Amy Groulx | Technician | 5506 Se Mitchell St, Portland, OR 97206 | 2019-11-08 |
| 1477061265 | Lisa Marie Matejka | Naturopath | 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 | 2018-01-16 |
| 1639625205 | Mollie Kathleen Pence | Registered Nurse | 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 | 2016-09-01 |
| 1457709164 | Lauren Murdoch | Massage Therapist | 4629 Southeast Woodstock Boulevard, Portland, OR 97206 | 2016-06-03 |
| 1962897785 | Meigra Simon LLC | Mechanotherapist | 6842 Se Henry St, Portland, OR 97206 | 2015-03-30 |
| 1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
| 1831597590 | Boey Yean Lim | Acupuncturist | 4629 Se Woodstock Blvd, Portland, OR 97206 | 2014-12-12 |
| 1295082329 | Chase Heywood Price | Acupuncturist | 5425 Se Raymond Street, Portland, OR 97206 | 2012-08-08 |
| 1154678423 | Annelise Sevastiana Schnase | Counselor | 4311 Se Woodstock Blvd, Portland, OR 97206 | 2012-08-06 |
| Find all providers in zip 97206 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558732966 | John William Thompson | Community Based Residential Treatment Facility, Mental Illness | 5538 Ne 24th Ave, Portland, OR 97211-6206 | 2015-10-12 |
| 1679941785 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 130 Se 119th Ave, Portland, OR 97216-3704 | 2015-09-04 |
| 1346637816 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Halsey Crc, Portland, OR 97230 | 2015-04-22 |
| 1700273638 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17700 Ne Halsey St, Portland, OR 97230-6734 | 2015-04-17 |
| 1447654504 | Cascadia Behavioral Health Care | Community Based Residential Treatment Facility, Mental Illness | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-10-20 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1821491853 | Florence Mutie | Community Based Residential Treatment Facility, Mental Illness | 5123 Sw 62nd Ave, Portland, OR 97221-1170 | 2014-10-05 |
| 1679983381 | Janus Youth Program | Community Based Residential Treatment Facility, Mental Illness | 142 Se 160th Ave Apt 24, Portland, OR 97233-3558 | 2014-05-02 |
| 1558606384 | Renew Consulting, Inc. | Community Based Residential Treatment Facility, Mental Illness | 12810 Sw 62nd Ave, Portland, OR 97219-8034 | 2012-12-05 |
| 1558686576 | Mentor Abi | Community Based Residential Treatment Facility, Mental Illness | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2010-04-01 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.