Organization
VICTOR TREATMENT CENTERS, INC.
Active
Other names
Victor-Lodi
Organization subpart
No
Provider details
NPI number
Authorized official
LENNY RAY VERSER JR. (CFO)
(530) 893-0758
Entity
Organization
Contact information
Practice address
12755 N HIGHWAY 88, LODI, CA 95240-9323
(209) 340-5800
(209) 340-5804
Mailing address
1360 E LASSEN AVE, CHICO, CA 95973-7823
(530) 893-0758
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00118
LEGAL ENTITY NUMBER - MH
CA
Enumeration date
12/07/2006
Last updated
02/13/2013
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