Provider Demographics
NPI:1124321724
Name:TELECARE ORANGE COUNTY CRISIS
Entity type:Organization
Organization Name:TELECARE ORANGE COUNTY CRISIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-245-7282
Mailing Address - Street 1:1171 CHERI DR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-2601
Mailing Address - Country:US
Mailing Address - Phone:562-245-7282
Mailing Address - Fax:562-245-7346
Practice Address - Street 1:1171 CHERI DR
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-2601
Practice Address - Country:US
Practice Address - Phone:562-245-7282
Practice Address - Fax:562-245-7346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TELECARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-21
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306004171323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility