TELECARE MENTAL HEALTH SERVICES OF OREGON, INC. (NPI# 1972814028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972814028 |
| Entity Type | Organization |
| Organization Name | TELECARE MENTAL HEALTH SERVICES OF OREGON, INC. |
| Other Organization Name | TELECARE 12TH STREET HOUSE |
| Practice Address |
1058 Ne 12th St Bend OR 97701-4412 |
| Mailing Address |
1080 Marina Village Pkwy Alameda CA 94501-6427 |
| Practice Telephone | 5103377950 |
| Practice Fax Number | 5103377969 |
| Mailing Telephone | 5103377950 |
| Mailing Fax Number | 5103377969 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |
| Authorized Official Name | MARSHALL LANGFELD (CFO, VP) |
| 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 12th Street House | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124310305 | Telecare Mental Health Services of Oregon, Inc. | Clinic/Center | 30 Ne Martin Luther King Blvd, Portland, OR 97232-2941 | 2011-05-06 |
| 1770804635 | Telecare Mental Health Services of Oregon, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1646 Ne Edgecliff Cir, Bend, OR 97701-4159 | 2010-06-15 |
| 1386767176 | Telecare Mental Health Services of Oregon, Inc. | Clinic/Center | 4101 Ne Division St, Suite 100, Gresham, OR 97030-4617 | 2007-04-09 |
| 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 |
1058 NE 12TH ST |
| City | BEND |
| State | OR |
| Zip Code | 97701-4412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770075475 | Amy Millikin | Counselor | 1058 Ne 12th St, Bend, OR 97701-4412 | 2018-05-30 |
| 1174921589 | Noel Dean | Counselor | 1058 Ne 12th St, Bend, OR 97701-4412 | 2014-12-17 |
| 1073895892 | Jessica Hutson | Counselor | 1058 Ne 12th St, Bend, OR 97701-4412 | 2011-09-16 |
| 1912291477 | Sara Rizzo | Counselor | 1058 Ne 12th St, Bend, OR 97701-4412 | 2011-06-01 |
| 1609171651 | Katie King | Counselor | 1058 Ne 12th St, Bend, OR 97701-4412 | 2011-01-24 |
| 1407160286 | Jay Edward Harris | Registered Nurse | 1058 Ne 12th St, Bend, OR 97701-4412 | 2010-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| 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 |
|---|---|---|---|---|
| 1871801704 | Telecare Mental Heatlh Service of Oregon, Inc | Community Based Residential Treatment Facility, Mental Illness | 20370 Poe Sholes Rd, Bend, OR 97701-7938 | 2010-09-14 |
| 1770804635 | Telecare Mental Health Services of Oregon, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1646 Ne Edgecliff Cir, Bend, OR 97701-4159 | 2010-06-15 |
| 1770754780 | Habilitation Coalition, LLC | Community Based Residential Treatment Facility, Mental Illness | 3316 Cruise Loop, Bend, OR 97701-8276 | 2008-03-18 |
| 1821544685 | Program Design Concepts, Inc | Community Based Residential Treatment Facility, Mental Illness | 22022 Nelson Rd, Bend, OR 97701-9790 | 2016-08-31 |
| 1588012363 | Evoke | Community Based Residential Treatment Facility, Mental Illness | 20332 Empire Ave, Suitef-7, Bend, OR 97703-5712 | 2016-06-02 |
| 1144677345 | Evoke | Community Based Residential Treatment Facility, Mental Illness | 20332 Empire Ave, Suite F-7, Bend, OR 97703-5712 | 2016-05-17 |
| 1841585833 | Telecare Corporation | Community Based Residential Treatment Facility, Mental Illness | 20370 Poe Sholes Dr, Bend, OR 97701-7938 | 2011-06-17 |
| 1013213420 | Telecare Corporation | Community Based Residential Treatment Facility, Mental Illness | 1646 Ne Edgecliff Cir, Bend, OR 97701-4159 | 2011-02-02 |
| 1972808822 | Jessie Kehaulani Higa | Community Based Residential Treatment Facility, Mental Illness | 20370 Poe Sholes Rd., Bend, OR 97701 | 2011-01-24 |
| 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 |
| 1538793856 | Tamekio Russell | Community Based Residential Treatment Facility, Mental Illness | 2072 Sw Sandlewood Pl, Gresham, OR 97080-9752 | 2020-02-25 |
| 1487290342 | Andrew J Thomas | Community Based Residential Treatment Facility, Mental Illness | 2568 Sw 1st Ave, Ontario, OR 97914-1877 | 2019-11-25 |
| 1760046528 | The Sachiko Group, Inc | Community Based Residential Treatment Facility, Mental Illness | 3517 Sw Wonderview Ave, Gresham, OR 97080-8574 | 2019-04-26 |
| 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 |
| 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.