# OUTREACH PROFESSIONAL SERVICE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cuyahoga Physician Network
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356650493
- **Authorized official:** MISTY A BLAYLOCK (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (440) 892-6406

## Contact information

- **Practice address:** 2322 E 22ND ST, SUITE 310, CLEVELAND, OH 44115-3176
- **Practice address phone:** (216) 363-2732
- **Practice address fax:** (216) 363-3304
- **Mailing address:** 26908 DETROIT RD, SUITE 301, WESTLAKE, OH 44145-2398
- **Mailing address phone:** (440) 617-1823
- **Mailing address fax:** (440) 617-0884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/06/2010
- **Last updated:** 10/06/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0251856 | — | OH |