| Victor Community Support Services, Inc | |
|
1545 S Holt Rd Stockton CA 95206-9618 | |
| (209) 969-5258 | |
| (530) 230-1265 |
| Full Name | Victor Community Support Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1545 S Holt Rd, Stockton, California |
| Authorized Official Name and Position | Angie R Wiechert (FINANCIAL ANALYST) |
| Authorized Official Contact | 5302301210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victor Community Support Services, Inc Po Box 5361 Chico CA 95927-5361 Ph: (530) 893-0758 | Victor Community Support Services, Inc 1545 S Holt Rd Stockton CA 95206-9618 Ph: (209) 969-5258 |
| NPI Number | 1003114810 |
|---|---|
| Provider Enumeration Date | 03/02/2011 |
| Last Update Date | 03/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003114810 | NPI | - | NPPES |
| 01042 | Other | CA | LEGAL ENTITY # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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