Healthcare Provider Details

I. General information

NPI: 1467862359
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 RENNER PKWY
RICHARDSON TX
75080-1316
US

IV. Provider business mailing address

269 RENNER PKWY
RICHARDSON TX
75080-1316
US

V. Phone/Fax

Practice location:
  • Phone: 972-840-7200
  • Fax: 512-973-8005
Mailing address:
  • Phone: 972-840-7200
  • 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: JULIE RYON
Title or Position: DIR OF ADMIN AND SUPPORT SERVICES
Credential:
Phone: 512-692-7834