Healthcare Provider Details

I. General information

NPI: 1124462890
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 N WASHINGTON ST SUITE A
SEYMOUR TX
76380-2556
US

IV. Provider business mailing address

505 E HUNTLAND DR SUITE 520
AUSTIN TX
78752-3717
US

V. Phone/Fax

Practice location:
  • Phone: 940-888-5586
  • Fax: 940-888-5743
Mailing address:
  • Phone: 512-750-8520
  • Fax: 512-973-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7336
License Number StateTX

VIII. Authorized Official

Name: SHERRY CUMMINGS
Title or Position: DIRECTOR OF CORPORATE COMPLIANCE
Credential: RN BSN CPHQ
Phone: 512-750-8520