Healthcare Provider Details

I. General information

NPI: 1942285440
Provider Name (Legal Business Name): S.C.C.H., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 DAWSON AVE
SIGNAL HILL CA
90806-5913
US

IV. Provider business mailing address

1880 DAWSON AVE
SIGNAL HILL CA
90755-5913
US

V. Phone/Fax

Practice location:
  • Phone: 562-494-5188
  • Fax:
Mailing address:
  • Phone: 562-494-5188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number940000159
License Number StateCA

VIII. Authorized Official

Name: MARC JOHNSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 949-373-8373