NPIMap

Organization Active NPI

Telecare Mental Heatlh Service of Oregon, Inc

Doing business as Telecare Deschutes County Recovery Center

  • Mental Illness Community Based Residential Treatment Facility
  • Bend, OR
National Provider Identifier
1871801704
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
TELECARE MENTAL HEATLH SERVICE OF OREGON, INC
Doing business as
Telecare Deschutes County Recovery Center
Practice address
20370 Poe Sholes Rd
Bend, OR 97701-7938
Phone
(541) 318-1377
Fax
(541) 383-4587
NPI assigned
Sep 14, 2010
Last updated
May 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

20370 Poe Sholes Rd
Bend, OR 97701-7938

Mailing address

1080 Marina Village Pkwy
Suite 100
Alameda, CA 94501-6427
Phone (510) 337-7950

Other identifiers 1

IdentifierTypeStateIssuer
500632287MedicaidOR

Other names 1

  • Telecare Deschutes County Recovery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070618000058 OR Part B Supplier - Clinic/Group Practice 1557460524 Receives reassigned benefits from 7 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Woodburn, OR; Gresham, OR; Bend, OR

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Telecare Mental Health of Oregon18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1871801704",
    "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": "945016427",
            "telephone_number": "510-337-7950",
            "fax_number": "510-337-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20370 POE SHOLES RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017938",
            "telephone_number": "541-318-1377",
            "fax_number": "541-383-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELECARE MENTAL HEATLH SERVICE OF OREGON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "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": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500632287",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telecare Deschutes County Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Telecare Deschutes County Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.