Healthcare Provider Details

I. General information

NPI: 1497092308
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2013
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4242 MEDICAL DRIVE, BLDG 1, SUITE 1100
SAN ANTONIO TX
78229
US

IV. Provider business mailing address

251 RENNER PKWY
RICHARDSON TX
75080-1316
US

V. Phone/Fax

Practice location:
  • Phone: 210-736-1812
  • Fax: 210-737-0843
Mailing address:
  • Phone: 512-692-7834
  • Fax: 972-792-6739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number007332
License Number StateTX

VIII. Authorized Official

Name: REBECCA WILLIAMS
Title or Position: ADVANCEDLEGAL/COMPLIANCESPECIALIST
Credential:
Phone: 214-538-6689