| Provider / Organization | NPI | Date Certified |
|---|---|---|
| IDENTITY OUTREACH PROGRAM CORP. | 1043928187 | 2023-03-12 |
The organization Identity Outreach Program Corp. is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1043928187. Registration indicates Identity Outreach Program Corp. is a provider of services with a specialization in Agencies, Case Management (Case Management, ) (Case Management, Agencies) (Respite Care Facility, Respite Care) (Respite Care: Respite Care, Mental Retardation and/or Developmental Disabilities, Child, ) (Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities, Child, Respite Care Facility) (Respite Care, )
| Code | Practice | License No State |
|---|---|---|
| 251B00000X | Agencies Case Management Case Management Case Management Agencies | |
| 385HR2060X PRIMARY | Respite Care Facility Respite Care Respite Care: Respite Care, Mental Retardation and/or Developmental Disabilities, Child Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities, Child Respite Care Facility Respite Care |