Provider Demographics
NPI:1962848127
Name:SOUTH COAST CHILDREN'S SOCIETY, INC.
Entity Type:Organization
Organization Name:SOUTH COAST CHILDREN'S SOCIETY, INC.
Other - Org Name:SOUTH COAST COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-838-4274
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:909-980-7000
Mailing Address - Fax:909-547-6552
Practice Address - Street 1:9500 HAVEN AVE
Practice Address - Street 2:SUITES 100, 175 & 2ND FLOOR
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5807
Practice Address - Country:US
Practice Address - Phone:909-980-6700
Practice Address - Fax:909-980-6003
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH COAST CHILDREN'S SOCIETY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-15
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36DBCIOtherCIS REPORTING UNIT
CA36FPEWOtherNEW SF REPORTING UNIT
CA36DBWROtherWRAP REPORTING UNIT
CA36DBEWOtherSF REPORTING UNIT
CA36FPCIOtherNEW CIS REPORTING