Provider Demographics
NPI:1124204334
Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity Type:Organization
Organization Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Other - Org Name:OUTREACH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-538-6689
Mailing Address - Street 1:251 RENNER PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1316
Mailing Address - Country:US
Mailing Address - Phone:972-840-7360
Mailing Address - Fax:972-792-6739
Practice Address - Street 1:251 RENNER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1316
Practice Address - Country:US
Practice Address - Phone:972-840-7360
Practice Address - Fax:972-840-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007339251E00000X, 251J00000X, 251E00000X
251X00000X, 253Z00000X, 333300000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No333300000XSuppliersEmergency Response System Companies
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185483801Medicaid
TX007339OtherHCSSA LICENSE