Organization
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGIE R WIECHERT (DIRECTOR OF FINANCIAL ANALYSIS)
(530) 230-1210
Entity
Organization
Contact information
Practice address
1908 BUSINESS CENTER DR, SAN BERNARDINO, CA 92408-3436
(909) 890-5930
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
—
—
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
11/12/2020
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