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NPI Code Detail

MEDICARE: SOUTH COAST CHILDREN'S SOCIETY, INC

MEDICARE: SOUTH COAST CHILDREN'S SOCIETY, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320800000XMental Illness Community Based Residential Treatment Facility1707237CA

General Provider Information

NPI Number : 1215017603
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH COAST CHILDREN'S SOCIETY, INC
Provider Business Mailing Address
First Line : 25910 ACERO STE 160
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-2777
Country : US
Telephone Number : 909-980-6700
Fax Number :
Provider Business Practice Location Address
First Line : 25910 ACERO STE 160
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-2777
Country : US
Telephone Number : 909-980-6700
Fax Number :
Authorized Official
Title or Position : CEO
Name : ELLEN MCGUIRK
Credential :
Telephone Number : 949-244-5757
Provider Enumeration Date : 10/17/2006
Last Update Date : 08/01/2022

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Directions to “SOUTH COAST CHILDREN'S SOCIETY, INC ” Practice Location

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