Provider Demographics
NPI:1316378359
Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity Type:Organization
Organization Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Other - Org Name:OUTREACH HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR OF ADMIN SUPPORT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-840-7360
Mailing Address - Street 1:269 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:972-792-6730
Practice Address - Street 1:269 RENNER PKWY
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:972-792-6730
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUTREACH HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-02
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007334OtherHCSSA / DADS LICENSE