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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
1251S00000XCommunity/Behavioral Health Agency1707237CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130DGOTHERCAWRAPAROUND

General Provider Information

NPI Number : 1497882161
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 : 701 W KIMBERLY AVE STE 120
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-6345
Country : US
Telephone Number : 714-966-8666
Fax Number :
Authorized Official
Title or Position : CEO
Name : ELLEN MCGUIRK
Credential :
Telephone Number : 949-244-5757
Provider Enumeration Date : 02/28/2007
Last Update Date : 11/19/2024

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

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