Organization
OUTREACH COMMUNITY LIVING SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. J PENELOPE KIDDER MA, LPCC (EXECUTIVE DIRECTOR)
(330) 263-0862
Entity
Organization
Contact information
Practice address
337 W NORTH ST, WOOSTER, OH 44691-4821
(330) 263-0862
(330) 262-8423
Mailing address
337 W NORTH ST, WOOSTER, OH 44691-4821
(330) 263-0862
(330) 262-8423
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
0184
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184
MENTAL HEALTH IDENTIFIER
OH
01
—
8500232
MR.DD STATE IDENTIFIER
OH
Enumeration date
05/02/2006
Last updated
08/22/2020
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