TELECARE MENTAL HEALTH SERVICES OF OREGON, INC (NPI# 1245624253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245624253 |
| Entity Type | Organization |
| Organization Name | TELECARE MENTAL HEALTH SERVICES OF OREGON, INC |
| Other Organization Name | TELECARE STULTS HOUSE |
| Practice Address |
805 Se 151st Ave Portland OR 97233-2916 |
| Mailing Address |
1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 |
| Practice Telephone | 9712717270 |
| Practice Fax Number | 9713026046 |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-04-23 |
| Authorized Official Name | MARSHALL LANGFELD (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 STULTS HOUSE | Other Name - Individual/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 |
| 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 |
| 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 |
805 SE 151ST AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-2916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134384688 | Jamie Deruyter | Counselor | 805 Se 151st Ave, Portland, OR 97233-2916 | 2008-07-24 |
| 1740895762 | Elisabeth Herzog | Case Manager/Care Coordinator | 805 Se 151st Ave, Portland, OR 97233-2916 | 2020-09-15 |
| 1255943106 | Katherine Colleen Pacheco | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2020-08-21 |
| 1346885019 | Timothy Sims | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-11-17 |
| 1629612411 | Shannon Marie Stronach | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-11-05 |
| 1477194330 | Daneen Pray | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-10-02 |
| 1639720998 | Paula Keyth | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-09-26 |
| 1376001792 | Jordan Alexander Niles | Case Manager/Care Coordinator | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-03-05 |
| 1619434743 | Joel T Kirkpatrick | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-02-25 |
| 1588132401 | Chase Steven Hardt | Psychiatric Residential Treatment Facility | 805 Se 151st Ave, Portland, OR 97233-2916 | 2018-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| 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.