Outreach 12

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

1918-A Issued in TX

Legal business name

OUTREACH 12

Doing business as

OUTREACH 12 Counseling Centers of Texas

Practice address

2208 Primrose Ave
Ste H-a
McAllen, TX 78504-4155

Phone

(956) 682-6889

Fax

(956) 682-6889

NPI assigned

Jun 28, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jackie Susan Webster-Neal, LCDC/ADCIIID/ICADC

Title

Program Director

Phone

(361) 568-3761

Specialties & licenses 1

Addresses

Other names 1

• OUTREACH 12 Counseling Centers of Texas Doing business as

Locations

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699771212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "ENCINO",
            "state": "TX",
            "postal_code": "783530147",
            "telephone_number": "361-325-4921",
            "fax_number": "361-325-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 PRIMROSE AVE",
            "address_2": "STE H-A",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785044155",
            "telephone_number": "956-682-6889",
            "fax_number": "956-682-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH 12",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEBSTER-NEAL",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "361-568-3761",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCDC/ADCIIID/ICADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TX",
            "license": "1918-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OUTREACH 12 Counseling Centers of Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Use Disorder Rehabilitation Clinic/Center in McAllen, TX
• Providers in McAllen, TX by specialty
• Substance Use Disorder Rehabilitation Clinic/Center 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.