| South Coast Community Services | |
|
9500 Haven Ave Suites 100, 175 & 2nd Floor Rancho Cucamonga CA 91730-5807 | |
| (909) 980-6700 | |
| (909) 980-6003 |
| Full Name | South Coast Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9500 Haven Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Kathleen Darling (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 9098384274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Coast Community Services 25910 Acero Ste 160 Mission Viejo CA 92691-2777 Ph: (909) 980-7000 | South Coast Community Services 9500 Haven Ave Suites 100, 175 & 2nd Floor Rancho Cucamonga CA 91730-5807 Ph: (909) 980-6700 |
| NPI Number | 1962848127 |
|---|---|
| Provider Enumeration Date | 05/15/2013 |
| Last Update Date | 08/01/2022 |
| Certification Date | 08/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962848127 | NPI | - | NPPES |
| 36DBCI | Other | CA | CIS REPORTING UNIT |
| 36FPEW | Other | CA | NEW SF REPORTING UNIT |
| 36DBWR | Other | CA | WRAP REPORTING UNIT |
| 36DBEW | Other | CA | SF REPORTING UNIT |
| 36FPCI | Other | CA | NEW CIS REPORTING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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