TELECARE MENTAL HEALTH SERVICES OF OREGON, INC. (NPI# 1124310305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124310305 |
| Entity Type | Organization |
| Organization Name | TELECARE MENTAL HEALTH SERVICES OF OREGON, INC. |
| Other Organization Name | TELECARE MULTNOMAH COUNTY CRISIS ASSESSMENT AND TREATMENT CENTER |
| Practice Address |
30 Ne Martin Luther King Blvd Portland OR 97232-2941 |
| Mailing Address |
1080 Marina Village Pkwy Suite 100 Alameda CA 94501-6427 |
| Practice Telephone | 5032321099 |
| Practice Fax Number | 5032323854 |
| Mailing Telephone | 5103377950 |
| Mailing Fax Number | 5103377969 |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2016-11-08 |
| 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 |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500635141 | 05 |
| Other Name | Type Code |
|---|---|
| Telecare Multnomah County Crisis Assessment and Treatment Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972814028 | Telecare Mental Health Services of Oregon, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1058 Ne 12th St, Bend, OR 97701-4412 | 2010-06-23 |
| 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 |
30 NE MARTIN LUTHER KING BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-2941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033717079 | Alicia Beth Pasik | Counselor | 30 Ne Martin Luther King Blvd, Portland, OR 97232-2941 | 2020-10-12 |
| 1316569221 | Angela Wolfer | Peer Specialist | 30 Ne Martin Luther King Blvd, Portland, OR 97232-2941 | 2020-05-13 |
| 1356974984 | Misha Denise Garcia | Registered Nurse | 30 Ne Martin Luther King Blvd, Portland, OR 97232-2941 | 2020-02-21 |
| 1750945259 | Cynthia Cascante | Peer Specialist | 30 Ne Martin Luther King Blvd, Portland, OR 97232-2941 | 2019-04-30 |
| 1881121911 | Shamus Micheal Rettler | Behavior Technician | 30 Ne Martin Luther King Blvd, Portland, OR 97232-2941 | 2017-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881851186 | Columbiacare Services | Psychiatric Residential Treatment Facility | 12501 Se Raymond St, Portland, OR 97236-3931 | 2008-05-22 |
| 1275620411 | Columbiacare Services | Psychiatric Residential Treatment Facility | 12511 Se Raymond St, Portland, OR 97236-3931 | 2006-10-09 |
| 1588132401 | Chase Steven Hardt | Psychiatric Residential Treatment Facility | 805 Se 151st Ave, Portland, OR 97233-2916 | 2018-11-08 |
| 1760939508 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 13221 Sw 68th Pkwy, Ste 440, Portland, OR 97223-8328 | 2016-09-09 |
| 1093186306 | Ginger's House | Psychiatric Residential Treatment Facility | 1000 Washington Ave, Portland, ME 04103-2751 | 2015-10-13 |
| 1588069801 | Columbiacare Services | Psychiatric Residential Treatment Facility | 17640 Ne Halsey St, Portland, OR 97230-6733 | 2014-10-29 |
| 1851592059 | Trillium Family Services, Inc. | Psychiatric Residential Treatment Facility | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2007-05-29 |
| 1215138425 | Trillium Family Services, Inc. | Psychiatric Residential Treatment Facility | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2007-05-29 |
| 1811198021 | Trillium Family Services | Psychiatric Residential Treatment Facility | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2007-05-29 |
| 1306987128 | Trillium Family Services | Psychiatric Residential Treatment Facility | 3550 Se Woodward St, Portland, OR 97202-1552 | 2007-02-12 |
| 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.