Provider Demographics
NPI:1063008225
Name:SOUTH COAST HOSPICE SERVICES,INC.
Entity Type:Organization
Organization Name:SOUTH COAST HOSPICE SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMENUI
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMITYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-247-0540
Mailing Address - Street 1:901 W CIVIC CENTER DR STE 200Z
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2352
Mailing Address - Country:US
Mailing Address - Phone:657-247-0540
Mailing Address - Fax:
Practice Address - Street 1:901 W CIVIC CENTER DR STE 200Z
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2352
Practice Address - Country:US
Practice Address - Phone:657-247-0540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based