Provider Demographics
NPI:1124287628
Name:OUTREACH HEALTH COMMUNITY CARE SERVICES LP
Entity type:Organization
Organization Name:OUTREACH HEALTH COMMUNITY CARE SERVICES LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-538-6689
Mailing Address - Street 1:2600 N CENTRAL EXPY STE 900
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2065
Mailing Address - Country:US
Mailing Address - Phone:214-538-6689
Mailing Address - Fax:972-792-6739
Practice Address - Street 1:16825 NORTHCHASE DR STE 160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-6004
Practice Address - Country:US
Practice Address - Phone:281-872-4495
Practice Address - Fax:281-872-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 3747P1801X, 251E00000X, 251E00000X, 251E00000X, 251E00000X, 385H00000X
TX007339251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX411935601Medicaid
TX411930701Medicaid
TX411241901Medicaid
TX413059301Medicaid
TX1855173-01Medicaid
TX3616484-01Medicaid
TX411221101Medicaid