Healthcare Provider Details

I. General information

NPI: 1306833074
Provider Name (Legal Business Name): CLATSOP CARE CENTER HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2005
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 16TH ST
ASTORIA OR
97103-3709
US

IV. Provider business mailing address

646 16TH ST
ASTORIA OR
97103-3709
US

V. Phone/Fax

Practice location:
  • Phone: 503-325-0313
  • Fax: 503-325-0115
Mailing address:
  • Phone: 503-325-0313
  • Fax: 503-325-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARK REMLEY
Title or Position: CEO
Credential:
Phone: 503-588-4428