Organization
SOUTH COAST TRAVERSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN MC GUIRK (CEO)
(949) 244-5757
Entity
Organization
Contact information
Practice address
590 TRAVERSE DR, COSTA MESA, CA 92626-3117
(714) 546-7731
Mailing address
25910 ACERO STE 160, MISSION VIEJO, CA 92691-2777
(909) 980-6700
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/22/2008
Last updated
08/01/2022
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