Healthcare Provider Details

I. General information

NPI: 1063698132
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5311 S MCCOLL RD
EDINBURG TX
78539-9168
US

IV. Provider business mailing address

505 E HUNTLAND DR SUITE 520
AUSTIN TX
78752-3717
US

V. Phone/Fax

Practice location:
  • Phone: 956-644-0963
  • Fax: 956-664-1013
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 Number007815
License Number StateTX

VIII. Authorized Official

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