# VICTOR TREATMENT CENTERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VTC Clover House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346739265
- **Authorized official:** ANGIE R WIECHERT (CONTROLLER)
- **Authorized official phone:** (530) 230-1210

## Contact information

- **Practice address:** 1136 CLOVER DR, SANTA ROSA, CA 95401-4512
- **Practice address phone:** (707) 575-7754
- **Mailing address:** 1360 E LASSEN AVE, CHICO, CA 95973-7823
- **Mailing address phone:** (530) 893-0758
- **Mailing address fax:** (530) 893-0502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 05/07/2018
- **Last updated:** 05/07/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00118 | LEGAL ENTITY NUMBER | CA |