Provider Demographics
NPI:1942651633
Name:OUTREACH HOUSING AND COMMUNITY INC.
Entity type:Organization
Organization Name:OUTREACH HOUSING AND COMMUNITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHALONDA
Authorized Official - Middle Name:NAKIA
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-274-1843
Mailing Address - Street 1:135 NORTH CLEVELAND
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-2002
Mailing Address - Country:US
Mailing Address - Phone:800-274-1843
Mailing Address - Fax:800-274-1843
Practice Address - Street 1:135 NORTH CLEVELAND
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-2002
Practice Address - Country:US
Practice Address - Phone:800-274-1843
Practice Address - Fax:800-274-1843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty