MEDICARE: OUTREACH COMMUNITY HEALTH CENTERS, 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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1245720499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUTREACH COMMUNITY HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	220 W CAPITOL DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-1185
Country	:	US
Telephone Number	:	414-727-6320
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 N 7TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1701
Country	:	US
Telephone Number	:	414-727-6315
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JULIA HARRIS ROBINSON
Credential	:
Telephone Number	:	414-964-9016

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	10/05/2023

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