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General NPI Number Information
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NPI Number | 1053471136
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Entity Type | Organization
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Legal Business Name | OUTREACH HEALTH COMMUNITY CARE SERVICES LC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/07/2015
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Provider Practice Location Address
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Address Line | 120 W MCLAIN ST
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City | SEYMOUR
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State | TX
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Zip | 76380-2537
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Country | US
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Telephone | 940-888-5586
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Fax | 940-888-5743
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Provider Business Mailing Address
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Address Line | 269 WEST RENNER PARKWAY
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City | RICHARDSON
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State | TX
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Zip | 75080
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Country | US
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Telephone | 512-692-7834
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Fax | 512-973-8005
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIVE AND SUPP
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Name | MS. JULIE LORRAINE RYON
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Credential |
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Telephone | 512-692-7834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 007336
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License Number State | TX
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