MEDICARE: OUTLOOK HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1063585529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUTLOOK HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 320
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-0320
Country	:	US
Telephone Number	:	651-674-4570
Fax Number	:	651-674-8740

Provider Business Practice Location Address
First Line	:	6413 OAK ST
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-5129
Country	:	US
Telephone Number	:	651-674-4570
Fax Number	:	651-674-8740

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BETTY NELSON
Credential	:
Telephone Number	:	651-674-4570

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/22/2020

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