# OUTREACH HEALTH INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528699352
- **Authorized official:** DR. CHESTER LEE WILSON JR. ED.D. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (386) 675-0098

## Contact information

- **Practice address:** 240 N FREDERICK AVE, DAYTONA BEACH, FL 32114-3400
- **Practice address phone:** (386) 255-5569
- **Practice address fax:** (386) 257-1245
- **Mailing address:** 240 N FREDERICK AVE, DAYTONA BEACH, FL 32114-3400
- **Mailing address phone:** (386) 255-5569
- **Mailing address fax:** (386) 257-1245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/30/2020
- **Last updated:** 01/30/2020