Telecare Mental Health Services of Oregon, Inc

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

TELECARE MENTAL HEALTH SERVICES OF OREGON, INC

Practice address

1605 E Lincoln Rd
Woodburn, OR 97071-5137

Phone

(503) 982-9300

Fax

(503) 982-9306

NPI assigned

Oct 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lorena Lopez

Title

Provider Relations Supervisor

Phone

(510) 337-7950

Specialties & licenses 1

Addresses

Other names 1

• Telecare Recovery Center at Woodburn Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Telecare Mental Health Services of Oregon, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
  • NPI 1184318065

  O20070618000058

  Same enrollment
• Telecare Mental Health Services of Oregon, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
  • NPI 1245624253

  O20070618000058

  Same enrollment
• Telecare Mental Health Services of Oregon, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
  • NPI 1659453686

  O20070618000058

  Same enrollment
• Telecare Mental Health Services of Oregon, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Gresham, OR
  • NPI 1740378371

  O20070618000058

  Same enrollment
• Telecare Mental Health Services of Oregon, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gresham, OR
  • NPI 1386767176

  O20070618000058

  Same enrollment
• Telecare Mental Heatlh Service of Oregon, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Bend, OR
  • NPI 1871801704

  O20070618000058

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1073601647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PKWY",
            "address_2": "SUITE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011078",
            "telephone_number": "510-337-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E LINCOLN RD",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970715137",
            "telephone_number": "503-982-9300",
            "fax_number": "503-982-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELECARE MENTAL HEALTH SERVICES OF OREGON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "510-337-7950"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telecare Recovery Center at Woodburn",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Telecare Recovery Center at Woodburn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Alexandra Sum Siquina, NP
• Cindy Sun
• Linda Swartout
• Diana Gonzalez Tapia
• Alison Tardie, RD
• Telecare Recovery Services
• Marisol Tello Vasquez
• Matthew Wayne Theeler Sr., CADC1
• Sarah Elizabeth Thomas, PHARM.D.
• Mary M Tippin, N.P.

• Psychiatric Residential Treatment Facility in Woodburn, OR
• Providers in Woodburn, OR by specialty
• Psychiatric Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.