NPI: 1184814477
Provider Name: VICTOR COMMUNITY SUPPORT SERVICES, INC
Doing Business As: VICTOR COMMUNITY SUPPORT SERVICES, STOCKTON
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization
Specialization: Adolescent and Children Mental Health
Address:
2495 W MARCH LN
SUITE 125 (MIOCR PROGRAM)
STOCKTON, CA
ZIP 95207
Phone: (209) 465-1080
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VICTOR COMMUNITY SUPPORT SERVICES, INC is an adolescent and children mental health clinic center in Stockton, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. VICTOR COMMUNITY SUPPORT SERVICES, INC NPI is 1184814477. The provider is registered as an organization entity type.
The provider Is Doing Business As Victor Community Support Services, Stockton.
The provider's business location address is:
2495 W MARCH LN
SUITE 125 (MIOCR PROGRAM)
STOCKTON, CA
ZIP 95207-251
Phone: (209) 465-1080
Fax: (209) 465-2709
The provider's authorized official is Angie Wiechert .
The authorized official title is Financial Analyst and has the following contact phone number (530) 230-1210.
The enumeration date for this NPI number is 8/1/2007 and was last updated on 12/20/2012.