Healthcare Provider Details

I. General information

NPI: 1366518441
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 CHEVY CHASE DR STE 450
AUSTIN TX
78752-1503
US

IV. Provider business mailing address

251 RENNER PKWY
RICHARDSON TX
75080-1316
US

V. Phone/Fax

Practice location:
  • Phone: 512-835-6150
  • Fax: 512-339-7906
Mailing address:
  • Phone: 214-538-6689
  • Fax: 972-792-6739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number007810
License Number StateTX

VIII. Authorized Official

Name: MS. REBECCA L WILLIAMS
Title or Position: CCD PROJECT MANAGER
Credential:
Phone: 214-538-6689