Provider Demographics
NPI:1932274966
Name:OUTREACH HEALTH COMMUNITY CARE SERVICES LP
Entity Type:Organization
Organization Name:OUTREACH HEALTH COMMUNITY CARE SERVICES LP
Other - Org Name:OUTREACH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-538-6689
Mailing Address - Street 1:251 RENNER PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1316
Mailing Address - Country:US
Mailing Address - Phone:214-538-6689
Mailing Address - Fax:972-792-6739
Practice Address - Street 1:85 NE LOOP 410 STE 620
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5866
Practice Address - Country:US
Practice Address - Phone:210-736-1812
Practice Address - Fax:210-737-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007332OtherHHSC
TX411967901Medicaid
TX358945901Medicaid
TX412768001Medicaid
TX412769801Medicaid
TX411961201Medicaid
TX412666601Medicaid