TELECARE MENTAL HEALTH SERVICES OF OREGON, INC (NPI# 1740378371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740378371 |
| Entity Type | Organization |
| Organization Name | TELECARE MENTAL HEALTH SERVICES OF OREGON, INC |
| Other Organization Name | TELECARE RECOVERY CENTER AT GRESHAM |
| Practice Address |
4104 Ne Division St Gresham OR 97030-4618 |
| Mailing Address |
1080 Marina Village Pkwy Suite 100 Alameda CA 94501-1078 |
| Practice Telephone | 5036666575 |
| Practice Fax Number | 5036664047 |
| Mailing Telephone | 5103377950 |
| Mailing Fax Number | 5103377969 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2017-01-27 |
| Authorized Official Name | LESLIE DAVIS (SVP, CFO) |
| 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 |
|---|---|
| Telecare Recovery Center at Gresham | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659453686 | Telecare Mental Health Services of Oregon, Inc | Community Based Residential Treatment Facility, Mental Illness | 7759 Se 72nd Ave, Portland, OR 97206-7921 | 2006-10-19 |
| 1073601647 | Telecare Mental Health Services of Oregon, Inc | Psychiatric Residential Treatment Facility | 1605 E Lincoln Rd, Woodburn, OR 97071-5137 | 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 |
4104 NE DIVISION ST |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-4618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| 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 |
|---|---|---|---|---|
| 1538793856 | Tamekio Russell | Community Based Residential Treatment Facility, Mental Illness | 2072 Sw Sandlewood Pl, Gresham, OR 97080-9752 | 2020-02-25 |
| 1760046528 | The Sachiko Group, Inc | Community Based Residential Treatment Facility, Mental Illness | 3517 Sw Wonderview Ave, Gresham, OR 97080-8574 | 2019-04-26 |
| 1023243508 | Sistere Inc. | Community Based Residential Treatment Facility, Mental Illness | 1610 W Powell Blvd, Gresham, OR 97030-6843 | 2009-05-27 |
| 1235506171 | Joyce Bailey | Community Based Residential Treatment Facility, Mental Illness | 4101 Ne Division St, Gresham, OR 97030-4617 | 2015-08-26 |
| 1710271861 | Lukedorf | Community Based Residential Treatment Facility, Mental Illness | 360 Sw 6th St, Gresham, OR 97080-9475 | 2011-06-07 |
| 1043503006 | Luke-dorf, Inc. | Community Based Residential Treatment Facility, Mental Illness | 360 Sw 6th St, Gresham, OR 97080-9475 | 2011-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932059 | Rainrock Treatment Center, LLC | Community Based Residential Treatment Facility, Mental Illness | 2990 Brandywine Dr, West Linn, OR 97068-8313 | 2020-11-06 |
| 1770101545 | Northwest Premier LLC | Community Based Residential Treatment Facility, Mental Illness | 560 W Rose St, Lebanon, OR 97355-2624 | 2020-07-08 |
| 1487290342 | Andrew J Thomas | Community Based Residential Treatment Facility, Mental Illness | 2568 Sw 1st Ave, Ontario, OR 97914-1877 | 2019-11-25 |
| 1831660984 | Olthyme LLC | Community Based Residential Treatment Facility, Mental Illness | 30803 Jeppeson Ln, Hermiston, OR 97838-6222 | 2018-12-16 |
| 1679073712 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 622 57th St, Springfield, OR 97478-6821 | 2018-02-15 |
| 1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
| 1558877407 | Best Care Treatment Services | Community Based Residential Treatment Facility, Mental Illness | 1470 Nw 4th St, Redmond, OR 97756-1366 | 2017-12-14 |
| 1831640192 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 8336 Highway 62, White City, OR 97530 | 2016-10-20 |
| 1740733906 | Trillium Family Services | Community Based Residential Treatment Facility, Mental Illness | 4545 Ne Highway 20, Corvallis, OR 97330-9655 | 2016-07-25 |
| 1871946640 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 29841 Hillcrest St, Gold Beach, OR 97444-8714 | 2016-07-18 |
| Find all providers with the same taxonomy | ||||
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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.