Provider Demographics
NPI:1760833313
Name:CLATSOP BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:CLATSOP BEHAVIORAL HEALTHCARE
Other - Org Name:NORTH COAST RESPITE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-325-5722
Mailing Address - Street 1:65 N HIGHWAY 101
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-9371
Mailing Address - Country:US
Mailing Address - Phone:503-325-5722
Mailing Address - Fax:503-861-2043
Practice Address - Street 1:326 SE MARLIN AVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-9624
Practice Address - Country:US
Practice Address - Phone:503-325-5722
Practice Address - Fax:503-861-2043
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLATSOP BEHAVIORAL HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-24
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness