Provider Demographics
NPI:1700167236
Name:OUTREACH CARE GROUP, INC
Entity Type:Organization
Organization Name:OUTREACH CARE GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-752-6819
Mailing Address - Street 1:724 PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-1474
Mailing Address - Country:US
Mailing Address - Phone:724-752-6819
Mailing Address - Fax:724-752-0966
Practice Address - Street 1:724 PERSHING ST
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-1474
Practice Address - Country:US
Practice Address - Phone:724-752-6819
Practice Address - Fax:724-752-0966
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUTREACH CARE GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty