| Organization Name: | SISKIYOU HOSPITAL, INC. |
| NPI Number: | 1093892275 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JONATHON C ANDRUS (CHEIF EXECUTIVE OFFICER) |
| Mailing Address: | 444 Bruce St Yreka |
| State: | CA US |
| Postal Code: | 960973450 |
| Phone Number: | 5308424121 |
| Fax Number: | 5308416242 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 12/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 230000035 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |