Provider Demographics
NPI:1902429251
Name:TELACARE HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:TELACARE HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:800-317-0280
Mailing Address - Street 1:11650 OLIO RD STE 1000-172
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7619
Mailing Address - Country:US
Mailing Address - Phone:800-317-0280
Mailing Address - Fax:
Practice Address - Street 1:11650 OLIO RD STE 1000-172
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7619
Practice Address - Country:US
Practice Address - Phone:800-317-0280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty