Organization
VICTOR COMMUNITY SUPPORT SERVICES, INC
Active
Other names
Victor Community Support Services, Stockton
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGIE WIECHERT (FINANCIAL ANALYST)
(530) 230-1210
Entity
Organization
Contact information
Practice address
2495 W MARCH LN, SUITE 125 (MIOCR PROGRAM), STOCKTON, CA 95207-8251
(209) 465-1080
(209) 465-2709
Mailing address
2561 CALIFORNIA PARK DR, CHICO, CA 95928-4166
(530) 893-0758
(530) 893-0502
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01042
LEGAL ENTITY #
CA
Enumeration date
08/01/2007
Last updated
12/20/2012
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