Healthcare Provider Details

I. General information

NPI: 1164598728
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N CENTRAL EXPY STE 900
RICHARDSON TX
75080-2065
US

IV. Provider business mailing address

2600 N CENTRAL EXPY STE 900
RICHARDSON TX
75080-2065
US

V. Phone/Fax

Practice location:
  • Phone: 214-703-1300
  • Fax: 972-792-6739
Mailing address:
  • Phone: 214-538-6689
  • Fax: 972-792-6739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: REBECCA L WILLIAMS
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 214-538-6689