Outreach Home # 3.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-032-355 Issued in NC

Legal business name

OUTREACH HOME # 3.

Practice address

1717 N Alston Ave
Durham, NC 27701-2301

Phone

(919) 683-2707

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Joy N. Okeke, RN

Title

Administrator

Phone

(919) 641-0162

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1649496928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SHALIMAR DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137571",
            "telephone_number": "919-683-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N ALSTON AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277012301",
            "telephone_number": "919-683-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH HOME # 3.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "OKEKE",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-641-0162",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-032-355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805420",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Our Daily Living
• Our Daily Living
• Lindsey Oury
• Rachel Carroll Outlaw, PHARMD
• Outreach Home # 2
• Outreach Home # 4
• Outreach Home #1
• Wen Chian Ouyang, RN, NP-C
• Forrest Dean Overaker
• Overandbeyondmeasurehealthcare

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Durham, NC
• Providers in Durham, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.