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Organization

VICTOR COMMUNITY SUPPORT SERVICES INC

Active
Other names
Victor Community Support Services, High Desert
Organization subpart
No

Provider details

NPI number
Authorized official
ANGIE R WIECHERT (DIRECTOR OF FINANCIAL ANLYSIS)
(530) 230-1210
Entity
Organization

Contact information

Practice address
15095 AMARGOSA RD STE 201&208, VICTORVILLE, CA 92394-1879
(760) 245-4695
(760) 780-4005
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
CA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01042
LEGAL ENTITY #
CA
Enumeration date
01/18/2007
Last updated
01/29/2023
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