NPIMap

Organization Active NPI

Outreach Community Care Network

  • Case Management Agency
  • Daytona Beach, FL
National Provider Identifier
1720260722
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
OUTREACH COMMUNITY CARE NETWORK
Practice address
240 N Frederick Ave
Suite a
Daytona Beach, FL 32114
Phone
(386) 255-5569
Fax
(386) 257-1245
NPI assigned
Nov 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Ms. Loretta Jennings
Title
Executive Director
Phone
(386) 255-5569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

240 N Frederick Ave
Suite a
Daytona Beach, FL 32114

Mailing address

PO Box 9177
Daytona Beach, FL 32120-9177
Phone (386) 255-5569

National Provider Directory

National Provider Directory
Tax ID family
Outreach Community Care Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

240 N Frederick Ave
Ste A
Daytona Beach, FL 32114
Phone (386) 255-5569

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1720260722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9177",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209177",
            "telephone_number": "386-255-5569",
            "fax_number": "386-257-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N FREDERICK AVE",
            "address_2": "SUITE A",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-255-5569",
            "fax_number": "386-257-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH COMMUNITY CARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "386-255-5569",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.