Healthcare Provider Details

I. General information

NPI: 1588920359
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 FOREST LN STE 101
GARLAND TX
75042-7928
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 972-840-7200
  • Fax: 972-840-7201
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 Number
License Number State

VIII. Authorized Official

Name: SHERRY CUMMINGS
Title or Position: DIRECTOR OF CORPORATE COMPLIANCE
Credential: RN, BSN
Phone: 512-750-8520