Healthcare Provider Details

I. General information

NPI: 1194064410
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3730-C S GESSNER RD
HOUSTON TX
77063-5132
US

IV. Provider business mailing address

251 RENNER PKWY
RICHARDSON TX
75080-1316
US

V. Phone/Fax

Practice location:
  • Phone: 281-872-4495
  • Fax: 281-872-4560
Mailing address:
  • Phone: 214-538-9668
  • 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: REBECCA L WILLIAMS
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 214-538-9668