Organization
OUTREACH COMMUNITY CARE NETWORK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANESSA HARVEY-LENTS DR.AD (EXECUTIVE DIRECTOR)
(386) 255-5569
Entity
Organization
Contact information
Practice address
240 N FREDERICK AVE, DAYTONA BEACH, FL 32114-3400
(386) 255-5569
(386) 257-1245
Mailing address
240 N FREDERICK AVE, P.O. BOX 9177 DAYTONA BEACH, FL 32120-9177, DAYTONA BEACH, FL 32114-3400
(386) 255-5569
(386) 257-1245
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
675880100
—
FL
Enumeration date
01/12/2017
Last updated
01/12/2017
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