Provider Demographics
NPI:1477604924
Name:CARE CENTERS MANAGEMENT, INC.
Entity Type:Organization
Organization Name:CARE CENTERS MANAGEMENT, INC.
Other - Org Name:MYRTLE POINT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:EMRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-884-0895
Mailing Address - Street 1:637 ASH ST
Mailing Address - Street 2:
Mailing Address - City:MYRTLE POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97458-1133
Mailing Address - Country:US
Mailing Address - Phone:541-572-2066
Mailing Address - Fax:541-572-5477
Practice Address - Street 1:637 ASH ST
Practice Address - Street 2:
Practice Address - City:MYRTLE POINT
Practice Address - State:OR
Practice Address - Zip Code:97458-1133
Practice Address - Country:US
Practice Address - Phone:541-572-2066
Practice Address - Fax:541-572-5477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0679037-8314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR800396Medicaid
OR385254Medicare Oscar/Certification