Provider Demographics
NPI:1154574184
Name:OUTREACH TRAINING AND SUPPORT SERVICES
Entity type:Organization
Organization Name:OUTREACH TRAINING AND SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-479-9217
Mailing Address - Street 1:610 W HUNDRED RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2519
Mailing Address - Country:US
Mailing Address - Phone:804-715-4198
Mailing Address - Fax:804-715-4199
Practice Address - Street 1:610 W HUNDRED RD STE A
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2519
Practice Address - Country:US
Practice Address - Phone:804-715-4198
Practice Address - Fax:804-715-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1147251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services