Provider Demographics
NPI:1760732309
Name:ASSURANCE HOSPICE SOUTH COAST, INC.
Entity Type:Organization
Organization Name:ASSURANCE HOSPICE SOUTH COAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:SANTIAGO
Authorized Official - Last Name:ARCILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-203-9297
Mailing Address - Street 1:2112 E 4TH ST
Mailing Address - Street 2:SUITE 228
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2112 E 4TH ST
Practice Address - Street 2:SUITE 228
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3840
Practice Address - Country:US
Practice Address - Phone:714-550-6081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based