Organization
CORONADO BAY, LLC
Active
Other names
Harvest Crossing Post-Acute
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN WILLIAMS (MANAGER)
(916) 945-1248
Entity
Organization
Contact information
Practice address
469 E NORTH ST, MANTECA, CA 95336-4710
(209) 823-1788
Mailing address
599 MENLO DR STE 200, ROCKLIN, CA 95765-3725
(916) 879-6560
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000071
—
CA
Enumeration date
01/25/2022
Last updated
01/25/2022
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