# SISKIYOU HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SISKIYOU HOSPITAL INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336330646
- **Legal business name:** SISKIYOU HOSPITAL INC
- **Authorized official:** JONATHON C ANDRUS (CEO)
- **Authorized official phone:** (530) 842-4121

## Contact information

- **Practice address:** 8 COMMERCIAL STREET, ETNA, CA 96027
- **Practice address phone:** (530) 467-5393
- **Practice address fax:** (530) 467-5355
- **Mailing address:** 444 BRUCE STREET, YREKA, CA 96097-3450
- **Mailing address phone:** (530) 841-6256
- **Mailing address fax:** (530) 842-0232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 230000035 | CA | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 12/26/2019