Provider Demographics
NPI:1942447099
Name:OUTREACH COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:OUTREACH COMMUNITY HEALTH CENTERS
Other - Org Name:HEALTHCARE FOR THE HOMELESS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-727-6320
Mailing Address - Street 1:711 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-3328
Mailing Address - Country:US
Mailing Address - Phone:414-727-6320
Mailing Address - Fax:
Practice Address - Street 1:711 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53206-3328
Practice Address - Country:US
Practice Address - Phone:414-727-6320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-12
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health