Provider Demographics
NPI:1689996951
Name:COMMUNITY OUT REACH OF NORTH AMERICA, INC
Entity Type:Organization
Organization Name:COMMUNITY OUT REACH OF NORTH AMERICA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHEDDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:318-230-5007
Mailing Address - Street 1:7803 MASTERS DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-4119
Mailing Address - Country:US
Mailing Address - Phone:318-230-5007
Mailing Address - Fax:318-364-8949
Practice Address - Street 1:7803 MASTERS DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-4119
Practice Address - Country:US
Practice Address - Phone:318-230-5007
Practice Address - Fax:318-364-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty