Provider Demographics
NPI:1013148196
Name:SOUTH COAST CHILDREN'S SOCIETY, INC
Entity type:Organization
Organization Name:SOUTH COAST CHILDREN'S SOCIETY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:MCGUIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-966-8650
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:714-966-8650
Mailing Address - Fax:714-428-3102
Practice Address - Street 1:1030 NEVADA ST STE 200
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2958
Practice Address - Country:US
Practice Address - Phone:877-527-7227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36ERMedicaid