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General NPI Number Information
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NPI Number | 1477662344
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Entity Type | Organization
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Legal Business Name | OUTREACH CARE INC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 2052 45TH ST
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City | HIGHLAND
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State | IN
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Zip | 46322-3759
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Country | US
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Telephone | 219-924-4007
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Fax | 219-924-4012
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Provider Business Mailing Address
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Address Line | 2052 45TH ST
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City | HIGHLAND
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State | IN
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Zip | 46322-3759
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Country | US
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Telephone | 219-924-4007
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Fax | 219-924-4012
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Authorized Official
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Title or Position | ADMINISTRATOR/DIRECTOR OF NURSING
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Name | MR. BRYAN O BEBERINO
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Credential | RN
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Telephone | 219-924-4007
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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 |
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License Number State | IN
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