South Coast Health & Wellness Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

250000115 Issued in CA

Legal business name

SOUTH COAST HEALTH & WELLNESS CORPORATION

Practice address

4768 Palm Ave
Riverside, CA 92501-4012

Phone

(951) 686-9001

Fax

(951) 686-0148

NPI assigned

Jul 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Cheryl Jumonville

Title

President/Owner

Phone

(951) 686-9001

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Community Care on Palm Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1104851716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4768 PALM AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014012",
            "telephone_number": "951-686-9001",
            "fax_number": "951-686-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4768 PALM AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014012",
            "telephone_number": "951-686-9001",
            "fax_number": "951-686-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST HEALTH & WELLNESS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "JUMONVILLE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "951-686-9001",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "250000115",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55711H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care on Palm",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Care on Palm",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Soul Counseling Services
• Sound Healthcare Corporation Dba Sound Medical Group
• Sound Inpatient Physicians Medical Group, Inc
• Jessica Emily Sousa
• Rachel Nicole Sousa
• Elexiona South
• Donnell Southall
• Southern California Emergency Medicine
• Southern California Emergency Medicine
• Southern California Emergency Medicine

• Skilled Nursing Facility in Riverside, CA
• Providers in Riverside, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.