Outreach Community Living Services Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

0184 Issued in OH

Legal business name

OUTREACH COMMUNITY LIVING SERVICES INC.

Practice address

337 W North St
Wooster, OH 44691-4821

Phone

(330) 263-0862

Fax

(330) 262-8423

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Ms. J Penelope Kidder, MA, LPCC

Title

Executive Director

Phone

(330) 263-0862

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699733600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 W NORTH ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446914821",
            "telephone_number": "330-263-0862",
            "fax_number": "330-262-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 W NORTH ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446914821",
            "telephone_number": "330-263-0862",
            "fax_number": "330-262-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH COMMUNITY LIVING SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIDDER",
        "authorized_official_first_name": "J PENELOPE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-263-0862",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OH",
            "license": "0184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH IDENTIFIER",
            "identifier": "0184",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MR.DD STATE IDENTIFIER",
            "identifier": "8500232",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ellen Ruprecht Owen, QMHS
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• Martin Owens

• Case Management Agency in Wooster, OH
• Providers in Wooster, OH by specialty
• Case Management Agency in Ohio

• 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.