Organization
VICTOR TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNI SHIPERLY (MENTAL HEALTH REHAB SPECIALIST)
(707) 291-8700
Entity
Organization
Contact information
Practice address
3164 CONDO CT, SANTA ROSA, CA 95403-2557
(707) 576-7218
Mailing address
3164 CONDO CT, SANTA ROSA, CA 95403-2557
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/23/2013
Last updated
05/23/2013
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