Provider Demographics
NPI:1538617477
Name:OUTER CAPE COMMUNITY OUTREACH
Entity type:Organization
Organization Name:OUTER CAPE COMMUNITY OUTREACH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:AVERNIS
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CNA,PCA,PSA
Authorized Official - Phone:508-332-6746
Mailing Address - Street 1:14 TERN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-2051
Mailing Address - Country:US
Mailing Address - Phone:508-332-6746
Mailing Address - Fax:
Practice Address - Street 1:14 TERN RD
Practice Address - Street 2:
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-2051
Practice Address - Country:US
Practice Address - Phone:508-332-6746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNIGHT-FORRESTER ENTERPRISE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACNA83659253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care