Provider Demographics
NPI:1548515794
Name:SOUTH COAST BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:SOUTH COAST BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KYLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-531-1821
Mailing Address - Street 1:2220 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3319
Mailing Address - Country:US
Mailing Address - Phone:949-531-1821
Mailing Address - Fax:714-709-8635
Practice Address - Street 1:2220 UNIVERSITY
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3319
Practice Address - Country:US
Practice Address - Phone:866-811-5249
Practice Address - Fax:714-556-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty