NPIMap

Organization Active NPI

Victor Community Support Services, Inc

  • Community/Behavioral Health Agency
  • Barstow, CA
National Provider Identifier
1184926495
Registry record updated Dec 13, 2024
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
222 E Main St Ste 113-117
Barstow, CA 92311-2361
Phone
(760) 245-4695
Fax
(760) 513-4696
NPI assigned
Nov 19, 2010
Last updated
Dec 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Angie R Wiechert
Title
Director of Financial Analysis
Phone
(530) 230-1210

Specialties & licenses 2

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

Addresses

Primary practice location

222 E Main St Ste 113-117
Barstow, CA 92311-2361

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

222 E Main St
Ste 101
Barstow, CA 92311

222 E Main St
Ste 112
Barstow, CA 92311
Phone (760) 256-2016

222 E Main St
Ste 113117
Barstow, CA 92311

NPI Registry JSON

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1184926495",
    "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": "222 E MAIN ST STE 113-117",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112361",
            "telephone_number": "760-245-4695",
            "fax_number": "760-513-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR COMMUNITY SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "WIECHERT",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCIAL ANALYSIS",
        "authorized_official_telephone_number": "530-230-1210"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGAL ENTITY #",
            "identifier": "01042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barstow, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.