| Telecare Casa Grande Act | |
|
1821 N Trekell Rd Suite 7 Casa Grande AZ 85122-1705 | |
| (520) 876-9293 | |
| (520) 876-9334 |
| Full Name | Telecare Casa Grande Act |
|---|---|
| Speciality | Clinic/Center |
| Location | 1821 N Trekell Rd, Casa Grande, Arizona |
| Authorized Official Name and Position | Lorena Lopez (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare Casa Grande Act 1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | Telecare Casa Grande Act 1821 N Trekell Rd Suite 7 Casa Grande AZ 85122-1705 Ph: (520) 876-9293 |
| NPI Number | 1356746762 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Medicare PECOS PAC ID | 6204155674 |
|---|---|
| Medicare Enrollment ID | O20150506001505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356746762 | NPI | - | NPPES |
| 987008 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | OTC6998 (Arizona) | Primary |
| Provider Name | Maryam H Lateef |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477533610 PECOS PAC ID: 3577475888 Enrollment ID: I20141023000369 |
| Provider Name | Josefina Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467800144 PECOS PAC ID: 2264725860 Enrollment ID: I20160719002604 |
| Provider Name | Devin L Wengert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346709557 PECOS PAC ID: 4284064197 Enrollment ID: I20200416002507 |
Casa Grande Inpatient Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 675 E Cottonwood Ln Ste 140, Casa Grande, AZ 85122 Phone: 520-426-0088 Fax: 480-775-2420 | |
Intermountain Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1821 N. Trekell Road, Suite 1, Casa Grande, AZ 85122 Phone: 520-426-4289 Fax: 520-421-0792 | |
Higher Heights Human Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 615 W Cottonwood Ln Ste 5-6, Casa Grande, AZ 85122 Phone: 702-772-5488 | |
Horizon Human Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 865 N. Arizola Rd, Casa Grande, AZ 85222 Phone: 520-421-2543 Fax: 520-421-1032 | |
Blue Bell Management Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 W 1st St, Casa Grande, AZ 85122 Phone: 520-463-3911 | |
Sun Life Family Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 865 N Arizola Rd, Casa Grande, AZ 85122 Phone: 520-836-3446 Fax: 520-836-8807 | |
Building Overcomers Wellness Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1821 N Trekell Rd, Casa Grande, AZ 85122 Phone: 623-522-2693 |