Provider Demographics
NPI:1295240869
Name:OUTREACH MEDICAL HOME HEALTH AGENCY
Entity type:Organization
Organization Name:OUTREACH MEDICAL HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DON
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD/RN
Authorized Official - Phone:972-293-3500
Mailing Address - Street 1:101 KENYA ST STE 114
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2806
Mailing Address - Country:US
Mailing Address - Phone:972-293-3500
Mailing Address - Fax:972-293-3514
Practice Address - Street 1:101 KENYA ST STE 114
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2806
Practice Address - Country:US
Practice Address - Phone:972-293-3500
Practice Address - Fax:972-293-3514
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAY CARRINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012286OtherTX LICENSE