Organization
OUTREACH CITY
Active
Other names
Outreach City
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN BENAMON (CHIEF EXECUTIVE OFFICER)
(404) 458-9997
Entity
Organization
Contact information
Practice address
201 17TH ST NW STE 300, ATLANTA, GA 30363-1191
(404) 458-9997
Mailing address
26671 LOGANBERRY DR, RICHMOND HEIGHTS, OH 44143-1142
(404) 458-9997
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
GA
251B00000X
Case Management Agency
—
OH
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
251S00000X
Community/Behavioral Health Agency
—
OH
252Y00000X
Early Intervention Provider Agency
—
GA
320800000X
Mental Illness Community Based Residential Treatment Facility
—
GA
Other
Enumeration date
07/06/2017
Last updated
06/16/2018
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