SHASTA CASCADE HEALTH CENTERS- MT SHASTA – NPI #1033675582
Clinic/Center

SHASTA CASCADE HEALTH CENTERS- MT SHASTA is an AHC clinic located in MOUNT SHASTA, CA. NPPES has assigned the NPI number 1033675582 to SHASTA CASCADE HEALTH CENTERS- MT SHASTA on February 20, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SHASTA CASCADE HEALTH CENTERS- MT SHASTA” is a dba name, the actual legal business name for this organization is MCCLOUD HEALTHCARE CLINIC, INC.. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was last updated on Nov 01, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHASTA CASCADE HEALTH CENTERS- MT SHASTA below.

NPI Profile for
MCCLOUD HEALTHCARE CLINIC, INC.

NPI Number
1033675582
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MCCLOUD HEALTHCARE CLINIC, INC.
Doing Business As (dba): SHASTA CASCADE HEALTH CENTERS- MT SHASTA
Primary location
824 PINE ST
MOUNT SHASTA, CA 96067-2137
Phone: (530) 926-4528 Fax:
Mailing address
PO BOX 1143
MCCLOUD, CA 96057-1143
Phone: (530) 964-2389 Fax:
Organization Subpart
Yes - SHASTA CASCADE HEALTH CENTERS- MT SHASTA is subpart of another organization.
Authorized Official
CALEB OTT
CEO
Phone: (530) 964-2389
Updated
Certification Date
Nov 01, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.