Healthcare Provider Details

I. General information

NPI: 1578971222
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/25/2014
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:
Mailing address:
  • Phone: 972-840-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: JULIE LORRAINE RYON
Title or Position: DIR OF ADIM SUPPORT SERVICES
Credential:
Phone: 512-968-9093