Provider Demographics
NPI:1669023164
Name:COMMUNITY OUTREACH HOME HEALTH
Entity Type:Organization
Organization Name:COMMUNITY OUTREACH HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:MAZORRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-397-3587
Mailing Address - Street 1:2717 COMMERCIAL CENTER BLVD STE E200-220
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7822
Mailing Address - Country:US
Mailing Address - Phone:281-397-3587
Mailing Address - Fax:281-397-3583
Practice Address - Street 1:2717 COMMERCIAL CENTER BLVD STE E200-220
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7822
Practice Address - Country:US
Practice Address - Phone:281-397-3587
Practice Address - Fax:281-397-3583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health