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General NPI Number Information
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NPI Number | 1124943709
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Entity Type | Organization
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Legal Business Name | THE OUTREACH INC.
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 475 WASHINGTON BLVD SUITE 19
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City | MARINA DEL REU
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State | CA
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Zip | 90292
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Country | US
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Telephone | 562-659-0950
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Fax | 310-974-4296
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Provider Business Mailing Address
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Address Line | 475 WASHINGTON BLVD SUITE 19
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City | MARINA DEL REU
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State | CA
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Zip | 90292
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Country | US
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Telephone | 562-659-0950
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Fax | 310-974-4296
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. DEIONNA L GIPSON
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Credential |
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Telephone | 562-659-0950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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