Organization
DEPARTMENT OF STATE HOSPITALS
Active
Other names
COALINGA STATE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE MAYNARD (ADMINISTRATIVE DEPUTY DIRECTOR)
(916) 651-3238
Entity
Organization
Contact information
Practice address
24511 W JAYNE AVE, COALINGA, CA 93210-9503
(559) 935-4300
(559) 935-7118
Mailing address
1215 O ST # MS -3, SACRAMENTO, CA 95814-5804
(916) 651-8906
(916) 651-8908
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
HPE47182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117241
PK
—
Enumeration date
05/12/2006
Last updated
10/19/2021
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