Provider Demographics
NPI:1407032584
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:DIRECTOR OF CORPORATE COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-692-7810
Mailing Address - Street 1:505 E HUNTLAND DR
Mailing Address - Street 2:SUITE 520
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3717
Mailing Address - Country:US
Mailing Address - Phone:512-692-7810
Mailing Address - Fax:512-973-8005
Practice Address - Street 1:1616 S KENTUCKY ST
Practice Address - Street 2:SUITE 130A
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-2252
Practice Address - Country:US
Practice Address - Phone:806-373-0986
Practice Address - Fax:806-373-5128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007335251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMAVA0001OtherVA