Provider Demographics
NPI:1205552817
Name:NEW OUTLOOK HOME CARE LLC
Entity type:Organization
Organization Name:NEW OUTLOOK HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDERRAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:458-256-5756
Mailing Address - Street 1:62049 NE NATES PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6981
Mailing Address - Country:US
Mailing Address - Phone:458-256-5756
Mailing Address - Fax:
Practice Address - Street 1:695 MISTLETOE RD STE 308
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9538
Practice Address - Country:US
Practice Address - Phone:458-256-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care