Healthcare Provider Details

I. General information

NPI: 1518143684
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
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: 940-888-5741
Mailing address:
  • Phone: 512-692-7810
  • Fax: 512-973-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number007336
License Number StateTX

VIII. Authorized Official

Name: SHERRY CUMMINGS
Title or Position: DIRECTOR OF CORPORATE COMPLIANCE
Credential:
Phone: 512-692-7810