Outreach Residential Services, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

656-01-001 Issued in VA

Legal business name

OUTREACH RESIDENTIAL SERVICES, INC.

Practice address

5032 Niles Rd
North Chesterfield, VA 23234-4538

Phone

(804) 743-8155

Fax

(804) 275-4267

NPI assigned

Oct 12, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Beverly Banks

Title

Owner

Phone

(804) 743-8155

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1710437801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5032 NILES RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232344538",
            "telephone_number": "804-743-8155",
            "fax_number": "804-275-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5032 NILES RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232344538",
            "telephone_number": "804-743-8155",
            "fax_number": "804-275-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-743-8155",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "656-01-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.