Provider Demographics
NPI:1093989923
Name:SOUTH COAST CHILDREN'S SOCIETY, INC.
Entity Type:Organization
Organization Name:SOUTH COAST CHILDREN'S SOCIETY, INC.
Other - Org Name:CYS SCCS SAN RAFAEL
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MC GUIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-244-5757
Mailing Address - Street 1:25910 ACERO STE 160
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2777
Mailing Address - Country:US
Mailing Address - Phone:909-980-6700
Mailing Address - Fax:714-966-8662
Practice Address - Street 1:17837 SAN RAFAEL ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5232
Practice Address - Country:US
Practice Address - Phone:714-968-3907
Practice Address - Fax:714-963-6581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children