STREET OUTREACH HEALTHCARE – NPI #1861231664
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

STREET OUTREACH HEALTHCARE is a substance abuse rehabilitation facility located in MESQUITE, TX. NPPES has assigned the NPI number 1861231664 to STREET OUTREACH HEALTHCARE on May 21, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STREET OUTREACH HEALTHCARE below.

NPI Profile for
STREET OUTREACH HEALTHCARE

NPI Number
1861231664
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STREET OUTREACH HEALTHCARE
Primary location
2379 GUS THOMASSON RD STE 400
MESQUITE, TX 75150-5302
Phone: (318) 751-7173 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MARDOSHA PEEK
CEO
Phone: (318) 751-7173
Updated
Certification Date
May 21, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
261QR0405X
- Clinic/Center / Rehabilitation, Substance Use Disorder
251B00000X
- Case Management

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.