Provider Demographics
NPI:1699951772
Name:OUTREACH HEALTH COMMUNITY CARE SERVICES
Entity type:Organization
Organization Name:OUTREACH HEALTH COMMUNITY CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-840-7360
Mailing Address - Street 1:269 RENNER PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1316
Mailing Address - Country:US
Mailing Address - Phone:972-840-7360
Mailing Address - Fax:972-792-6739
Practice Address - Street 1:120 W MCLAIN ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TX
Practice Address - Zip Code:76380-2537
Practice Address - Country:US
Practice Address - Phone:940-888-5586
Practice Address - Fax:940-888-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007336251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000681400OtherREGION 2 CBA