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Organization
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Active
Organization
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Active
Other names
Victor Community Support Services, Fairfield - Webster St.
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE R WIECHERT (DIRECTOR OF FINANCIAL ANALYSIS)
(530) 230-1210
Entity
Organization
Contact information
Practice address
733 WEBSTER ST, FAIRFIELD, CA 94533-5520
(707) 425-5744
Mailing address
1360 E LASSEN AVE, CHICO, CA 95973-7823
(530) 893-0758
(530) 893-0502
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01042
LEGAL ENTITY NUMBER
CA
Enumeration date
05/05/2022
Last updated
09/19/2024
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