| Victor Community Support Services, Inc. | |
|
1908 Business Center Dr San Bernardino CA 92408-3436 | |
| (909) 890-5930 | |
| Not Available |
| Full Name | Victor Community Support Services, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1908 Business Center Dr, San Bernardino, California |
| Authorized Official Name and Position | Angie R Wiechert (DIRECTOR OF FINANCIAL ANALYSIS) |
| 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. 1360 E Lassen Ave Chico CA 95973-7823 Ph: (530) 893-0758 | Victor Community Support Services, Inc. 1908 Business Center Dr San Bernardino CA 92408-3436 Ph: (909) 890-5930 |
| NPI Number | 1982756714 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982756714 | NPI | - | NPPES |
| 01042 | Other | CA | LEGAL ENTITY # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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