Provider Demographics
NPI:1639641939
Name:SOUTH COUNTY HOME HEALTH INC.
Entity Type:Organization
Organization Name:SOUTH COUNTY HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTINOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-338-9223
Mailing Address - Street 1:2 S POINTE DR STE 135
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-2295
Mailing Address - Country:US
Mailing Address - Phone:949-338-9223
Mailing Address - Fax:
Practice Address - Street 1:2 S POINTE DR STE 135
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-2295
Practice Address - Country:US
Practice Address - Phone:949-338-9223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-26
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health