Outreach Assisted Living Facility 2

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

117656 VENDOR 100958 Issued in TX

Legal business name

OUTREACH ASSISTED LIVING FACILITY 2

Practice address

5010 Ridgeway Dr
Houston, TX 77033-3541

Phone

(713) 459-1753

Fax

(713) 988-5323

NPI assigned

May 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fair Vivard Clarke, LBSWNPI 1649867565

Title

Owner

Phone

(713) 459-1753

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fair Vivard Clarke

  • Assisted Living Facility
  • Houston, TX
  • NPI 1649867565
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104038264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 RIDGEWAY DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770333541",
            "telephone_number": "713-731-0645",
            "fax_number": "713-998-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 RIDGEWAY DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770333541",
            "telephone_number": "713-459-1753",
            "fax_number": "713-988-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH ASSISTED LIVING FACILITY 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "FAIR",
        "authorized_official_middle_name": "VIVARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-459-1753",
        "authorized_official_credential": "LBSW"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "117656 VENDOR 100958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LTC PROVIDER",
            "identifier": "10026531",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Outpatient Clinical Care, P.a.
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• Outpatient Women'S and Children'S Surgery Center, LTD
• Beverly Ann Outram, SURGICAL ASSISTANT
• Outreach Diagnostic Clinic
• Outreach for the Aged Inc.
• Outreach Health Community Care Services LP
• Outreach Health Community Care Services, L.P.
• Outreach Health Community Care Services, L.P.

• Assisted Living Facility in Houston, TX
• Providers in Houston, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.