Provider Demographics
NPI:1437224193
Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LC
Entity Type:Organization
Organization Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LC
Other - Org Name:OUTREACH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADVANCED LEGAL/COMPLIANCE SPECIALIS
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:512-692-7834
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:512-692-7834
Mailing Address - Fax:972-792-6739
Practice Address - Street 1:251 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:972-840-7200
Practice Address - Fax:972-840-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXERS SERVICES251E00000X
TXPP0130251E00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001003653OtherCBA
TX001003653OtherREGION 5 BEAUMONT CBA