Healthcare Provider Details

I. General information

NPI: 1306055124
Provider Name (Legal Business Name): PEOPLE FIRST OUTREACH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 12/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 JORDAN ST STE 215
SHREVEPORT LA
71101-4519
US

IV. Provider business mailing address

820 JORDAN ST STE 215
SHREVEPORT LA
71101-4519
US

V. Phone/Fax

Practice location:
  • Phone: 318-681-9988
  • Fax: 318-681-9928
Mailing address:
  • Phone: 318-681-9988
  • Fax: 318-681-9928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number9633 SIL
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ROBINETT WEBB
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 318-681-9988