Healthcare Provider Details

I. General information

NPI: 1629254842
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: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PENNBRIGHT DR STE 104
HOUSTON TX
77090-5907
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: 512-692-7834
  • Fax: 972-792-6739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. REBECCA L WILLIAMS
Title or Position: CORPORATE LEGAL MANAGER
Credential:
Phone: 214-703-1310