Healthcare Provider Details

I. General information

NPI: 1568894673
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E HUNTLAND DR SUITE 550B
AUSTIN TX
78752-3717
US

IV. Provider business mailing address

505 E HUNTLAND DR 520
AUSTIN TX
78752-3717
US

V. Phone/Fax

Practice location:
  • Phone: 512-835-6150
  • Fax: 512-339-7906
Mailing address:
  • Phone: 512-692-7810
  • Fax: 512-973-8005

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: SHERRY MARLENE CUMMINGS
Title or Position: DIRECTOR OF CORPORATE COMPLIANCE
Credential: RN
Phone: 512-692-7810