Organization
MCCLOUD HEALTHCARE CLINIC, INC.
Active
Organization
MCCLOUD HEALTHCARE CLINIC, INC.
Active
Other names
Shasta Cascade Health Centers- Dunsmuir
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALEB J OTT (CEO)
(530) 964-2389
Entity
Organization
Contact information
Practice address
4309 STAGECOACH ROAD, DUNSMUIR, CA 96025
(530) 235-4138
(530) 378-2453
Mailing address
PO BOX 1143, MCCLOUD, CA 96057-1143
(530) 964-2389
(530) 964-3141
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550001195
CA
261QR1300X
Rural Health Clinic/Center
G32096
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G320960
—
CA
Enumeration date
09/17/2012
Last updated
11/01/2024
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