NPIMap

Organization Active NPI

Victor Community Support Services, Inc.

  • Community/Behavioral Health Agency
  • Lake Elsinore, CA
National Provider Identifier
1093868838
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Practice address
265 San Jacinto River Rd
Suite 106,107, 201-207
Lake Elsinore, CA 92530
Phone
(951) 674-9243
Fax
(951) 674-9635
NPI assigned
Jan 18, 2007
Last updated
Jan 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Angie R Wiechert
Title
Director Or Financial Analysis
Phone
(530) 230-1210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

265 San Jacinto River Rd
Suite 106,107, 201-207
Lake Elsinore, CA 92530

Mailing address

1360 E Lassen Ave
Chico, CA 95973-7823
Phone (530) 893-0758

Other identifiers 1

IdentifierTypeStateIssuer
01042OtherCALEGAL ENTITY #

National Provider Directory

National Provider Directory
Tax ID family
Victor Community Support Services Inc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

265 San Jacinto River Rd
Ste 106107
Lake Elsinore, CA 92530
Phone (951) 674-9243

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1093868838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E LASSEN AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737823",
            "telephone_number": "530-893-0758",
            "fax_number": "530-893-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 SAN JACINTO RIVER RD",
            "address_2": "SUITE 106,107, 201-207",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "92530",
            "telephone_number": "951-674-9243",
            "fax_number": "951-674-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR COMMUNITY SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "WIECHERT",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OR FINANCIAL ANALYSIS",
        "authorized_official_telephone_number": "530-230-1210",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGAL ENTITY #",
            "identifier": "01042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.