Provider Demographics
NPI:1184799843
Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity type:Organization
Organization Name:OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMIN AND SUPPORT SRVCS
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-840-7360
Mailing Address - Street 1:269 RENNER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:972-840-7360
Mailing Address - Fax:972-792-6739
Practice Address - Street 1:269 WEST RENNER PARKWAY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:512-692-7834
Practice Address - Fax:512-973-8005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUTREACH HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-21
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333300000X
TXPP0130251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXREGION 03OtherCCAD-DADS
TX100TOCERSOtherERS TOUCH OF CLASS
TX000155100OtherREGION 3 GARLAND CCAD