Provider Demographics
NPI:1184165086
Name:SOUTH COUNTY REGISTRY
Entity type:Organization
Organization Name:SOUTH COUNTY REGISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPPARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-600-7031
Mailing Address - Street 1:24451 RAYMOND WAY, SUITE 145
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92630
Mailing Address - Country:US
Mailing Address - Phone:949-600-7031
Mailing Address - Fax:949-600-6183
Practice Address - Street 1:24551 RAYMOND WAY
Practice Address - Street 2:SUITE 145
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4400
Practice Address - Country:US
Practice Address - Phone:949-600-7031
Practice Address - Fax:949-600-6183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304700060253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care