Provider Demographics
NPI:1386820595
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:MS
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 1:3730-C S GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5132
Practice Address - Country:US
Practice Address - Phone:281-872-4495
Practice Address - Fax:281-872-4560
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUTREACH HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-17
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007810251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007810OtherHCSSA LICENSE
TX185495201Medicaid