Provider Demographics
NPI:1225337314
Name:URBAN HEALTH OUTREACH, LLC
Entity Type:Organization
Organization Name:URBAN HEALTH OUTREACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREEN-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:313-664-0100
Mailing Address - Street 1:3031 W GRAND BLVD
Mailing Address - Street 2:SUITE 675
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3046
Mailing Address - Country:US
Mailing Address - Phone:313-664-0100
Mailing Address - Fax:313-664-0111
Practice Address - Street 1:3031 W GRAND BLVD
Practice Address - Street 2:SUITE 675
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3046
Practice Address - Country:US
Practice Address - Phone:313-664-0100
Practice Address - Fax:313-664-0111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URBAN HOSPITAL CARE PLUS D/B/A URBAN HEALTH RESOURCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-15
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health