Healthcare Provider Details

I. General information

NPI: 1780768416
Provider Name (Legal Business Name): THC - ORANGE COUNTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 N BREA BLVD
BREA CA
92821
US

IV. Provider business mailing address

875 N BREA BLVD
BREA CA
92821-2606
US

V. Phone/Fax

Practice location:
  • Phone: 714-529-6842
  • Fax: 714-256-1041
Mailing address:
  • Phone: 714-529-6842
  • Fax: 714-256-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number060000407
License Number StateCA

VIII. Authorized Official

Name: KATHY TEAGUE
Title or Position: VICE PRESIDENT, CORPORATE SECRETARY
Credential:
Phone: 629-253-5121