Provider Demographics
NPI:1427486786
Name:TRI STATE OUTREACH SERVICES
Entity type:Organization
Organization Name:TRI STATE OUTREACH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-724-9977
Mailing Address - Street 1:226 CHURCH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4981
Mailing Address - Country:US
Mailing Address - Phone:214-724-9977
Mailing Address - Fax:972-223-2831
Practice Address - Street 1:226 CHURCH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4981
Practice Address - Country:US
Practice Address - Phone:214-724-9977
Practice Address - Fax:972-223-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty