Provider Demographics
NPI:1467835181
Name:STRAWBERRY CREEK OUTREACH CENTER
Entity Type:Organization
Organization Name:STRAWBERRY CREEK OUTREACH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-819-6475
Mailing Address - Street 1:1060 W PIPELINE RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4732
Mailing Address - Country:US
Mailing Address - Phone:817-819-6475
Mailing Address - Fax:817-616-3543
Practice Address - Street 1:1060 W PIPELINE RD
Practice Address - Street 2:STE. 100
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4732
Practice Address - Country:US
Practice Address - Phone:817-819-6475
Practice Address - Fax:817-616-3543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty