Healthcare Provider Details
I. General information
NPI: 1255517454
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2008
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
- Phone: 281-872-4495
- Fax: 281-872-4560
- Phone: 972-840-7360
- Fax: 972-792-6739
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
REBECCA
L
WILLIAMS
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 214-538-6689