1851668842 NPI number — SOUTH COAST CHILDREN'S SOCIETY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851668842 NPI number — SOUTH COAST CHILDREN'S SOCIETY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH COAST CHILDREN'S SOCIETY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SOUTH COAST COMMUNITY SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851668842
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25910 ACERO STE 160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSION VIEJO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92691-2777
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-980-7000
Provider Business Mailing Address Fax Number:
909-547-6552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1425 W. FOOTHILL BLVD.
Provider Second Line Business Practice Location Address:
# 201 ,# 310
Provider Business Practice Location Address City Name:
UPLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-980-6700
Provider Business Practice Location Address Fax Number:
909-980-6003
Provider Enumeration Date:
11/19/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DARLING
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
909-838-4274

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 36FPTB , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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