Provider Demographics
NPI:1477662344
Name:OUTREACH CARE INC
Entity Type:Organization
Organization Name:OUTREACH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:BEBERINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:219-924-4007
Mailing Address - Street 1:2052 45TH ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-3759
Mailing Address - Country:US
Mailing Address - Phone:219-924-4007
Mailing Address - Fax:219-924-4012
Practice Address - Street 1:2052 45TH ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-3759
Practice Address - Country:US
Practice Address - Phone:219-924-4007
Practice Address - Fax:219-924-4012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health