# CORONADO BAY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harvest Crossing Post-Acute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053063685
- **Authorized official:** RYAN WILLIAMS (MANAGER)
- **Authorized official phone:** (916) 945-1248

## Contact information

- **Practice address:** 469 E NORTH ST, MANTECA, CA 95336-4710
- **Practice address phone:** (209) 823-1788
- **Mailing address:** 599 MENLO DR STE 200, ROCKLIN, CA 95765-3725
- **Mailing address phone:** (916) 879-6560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 01/25/2022
- **Last updated:** 01/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100000071 | — | CA |