Healthcare Provider Details

I. General information

NPI: 1457537664
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 W FERGUSON RD
MT PLEASANT TX
75455-2002
US

IV. Provider business mailing address

251 RENNER PKWY
RICHARDSON TX
75080-1316
US

V. Phone/Fax

Practice location:
  • Phone: 903-575-9251
  • Fax: 903-575-9771
Mailing address:
  • Phone: 214-703-1310
  • Fax: 972-792-6739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number007339
License Number StateTX

VIII. Authorized Official

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