Provider Demographics
NPI:1518029123
Name:OUTREACH FOR THE AGED INC.
Entity Type:Organization
Organization Name:OUTREACH FOR THE AGED INC.
Other - Org Name:DBA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:832-868-6339
Mailing Address - Street 1:6400 W LITTLE YORK RD
Mailing Address - Street 2:STE.# 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-1110
Mailing Address - Country:US
Mailing Address - Phone:832-868-6339
Mailing Address - Fax:281-342-3376
Practice Address - Street 1:6400 WEST LITTLE YORK
Practice Address - Street 2:STE. #104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091
Practice Address - Country:US
Practice Address - Phone:832-868-6339
Practice Address - Fax:281-342-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies