Organization
DEPARTMENT OF STATE HOSPITALS
Active
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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