NPIMap

Organization Active NPI

Victor Treatment Centers, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Rosa, CA
National Provider Identifier
1346739265
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
VICTOR TREATMENT CENTERS, INC.
Practice address
1136 Clover Dr
Santa Rosa, CA 95401-4512
Phone
(707) 575-7754
NPI assigned
May 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Authorized official

Name
Angie R Wiechert
Title
Controller
Phone
(530) 230-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

1136 Clover Dr
Santa Rosa, CA 95401-4512

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00118OtherCALEGAL ENTITY NUMBER

Other names 1

  • VTC Clover House Other name

National Provider Directory

National Provider Directory
Tax ID family
Victor Treatment Centers Inc31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1346739265",
    "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": "1136 CLOVER DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014512",
            "telephone_number": "707-575-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR TREATMENT CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "WIECHERT",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "530-230-1210"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGAL ENTITY NUMBER",
            "identifier": "00118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VTC Clover House",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "VTC Clover House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.