Provider Demographics
NPI:1598956518
Name:OUTREACH HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:OUTREACH HOME HEALTH SERVICES INC
Other - Org Name:DARLENE PRIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:CLINICAL NURSE SPEC
Authorized Official - Phone:216-791-7001
Mailing Address - Street 1:12025 LARCHMERE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120
Mailing Address - Country:US
Mailing Address - Phone:216-791-7001
Mailing Address - Fax:216-791-7001
Practice Address - Street 1:12025 LARCHMERE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120
Practice Address - Country:US
Practice Address - Phone:216-791-7001
Practice Address - Fax:216-371-8763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2234773251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2234773OtherMEDICARE
OH2234773Medicaid
OH2234773OtherMEDICARE