VICTOR COMMUNITY SUPPORT SERVICES, INC.


Address: 15400 Cholame Rd, Victorville, CA 92392-2480
Phone: 7602435417

VICTOR COMMUNITY SUPPORT SERVICES, INC. (NPI# 1831369099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1831369099
Entity Type Organization
Organization Name VICTOR COMMUNITY SUPPORT SERVICES, INC.
Other Organization Name VICTOR COMMUNITY SUPPORT SERVICES, HIGH DESERT
Practice Address 15400 Cholame Rd
Victorville
CA 92392-2480
Mailing Address 1360 E Lassen Ave
Chico
CA 95973-7823
Practice Telephone 7602435417
Practice Fax Number 7607804591
Mailing Telephone 5308930758
Mailing Fax Number 5308930502
Enumeration Date 2008-03-04
Last Update Date 2019-02-19
Authorized Official Name MS. ANGIE R WIECHERT (DIRECTOR OF FINANCIAL ANALYSIS)
Authorized Official Telephone 5302301210
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities
Y 251S00000X Community/Behavioral Health CA Agencies

Other Provider Identifier

State Issuer Identifier Type Code
CA LEGAL ENTITY # 01042 01

Other Provider/Organization Names

Other Name Type Code
Victor Community Support Services, High Desert Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1215579628 Victor Community Support Services, Inc. Clinic/Center 302 Cherry Ln Ste 101&201, Manteca, CA 95337-4311 2019-10-17
1780957282 Victor Community Support Services, Inc. Clinic/Center 600 N Arrowhead Ave Ste 300, San Bernardino, CA 92401-1148 2012-02-14
1629240270 Victor Community Support Services, Inc. Clinic/Center 555 N Perris Blvd Bldg A, Perris, CA 92571-2811 2008-03-24
1972689370 Victor Community Support Services, Inc. Community/Behavioral Health 1360 E Lassen Ave, Chico, CA 95973-7823 2006-10-27
1366950784 Victor Community Support Services, Inc. Clinic/Center 1105 E Florida Ave, Hemet, CA 92543-4512 2018-01-19
1851670418 Victor Community Support Services, Inc. Clinic/Center 1053 N D St, San Bernardino, CA 92410-3521 2011-08-12
1922306620 Victor Community Support Services, Inc. Community/Behavioral Health 555 N Perris Blvd, Perris, CA 92571-2811 2011-03-03
1417264185 Victor Community Support Services, Inc. Clinic/Center 3050 Beacon Blvd Ste 103, West Sacramento, CA 95691-3467 2010-09-01
1669703427 Victor Community Support Services, Inc. Clinic/Center 265 San Jacinto River Rd, Suite 106, 107, 201-207, Lake Elsinore, CA 92530 2010-01-19
1932251980 Victor Community Support Services, Inc. Community/Behavioral Health 2495 W March Ln, Suite 125, Stockton, CA 95207-8251 2007-01-18

Office Location

Street Address 15400 CHOLAME RD
City VICTORVILLE
State CA
Zip Code 92392-2480

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306977913 Mary Ann Speight Marriage & Family Therapist 15400 Cholame Rd, Victorville, CA 92392-2480 2007-03-07
1760080493 Isaiah Daniel Heller Peer Specialist 15400 Cholame Rd, Victorville, CA 92392-2480 2020-10-14
1194332924 Cassandra Munoz Counselor 15400 Cholame Rd, Victorville, CA 92392-2480 2020-09-25
1174130165 Joann C Castro Community Health Worker 15400 Cholame Rd, Victorville, CA 92392-2480 2020-09-24
1457968398 Kimberly Michelle Bruno Social Worker 15400 Cholame Rd, Victorville, CA 92392-2480 2020-09-24
1316553324 Israel Cox Community Health Worker 15400 Cholame Rd, Victorville, CA 92392-2480 2020-09-16
1730795758 Amanda Lauren Talbot Community Health Worker 15400 Cholame Rd, Victorville, CA 92392-2480 2020-09-16
1306464938 Glycell Robledo Felix Community Health Worker 15400 Cholame Rd, Victorville, CA 92392-2480 2020-07-09
1669093761 Paula Joy Espinosa-shaw Community Health Worker 15400 Cholame Rd, Victorville, CA 92392-2480 2020-04-29
1730716457 Oleg Tsabur Counselor 15400 Cholame Rd, Victorville, CA 92392-2480 2020-03-24
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215568688 Kristin Parris Behavior Technician 15490 Civic Drive, Victorville, CA 92392 2020-02-03
1366001604 Pine Ridge Treatment Centers, Inc. Substance Abuse Rehabilitation Facility 15367 Bonanza Rd, Ste A, Victorville, CA 92392 2019-06-11
1851871289 Betty A. Murphy, Lmft, Inc Marriage & Family Therapist 15437 Anacapa Rd. Ste 26, Victorville, CA 92392 2018-08-15
1104313402 Jorge L Soler Iglesias Nurse Practitioner 12459 Cricket St., Victorville, CA 92392 2018-04-23
1689192049 Jamesina Johns Nurse Practitioner 12127 Mall Blvd #148, Victorville, CA 92392 2017-09-06
1285151886 Jasmin Sanchez Behavioral Analyst 13201 Eclipse Ave, Victorville, CA 92392 2017-08-24
1174049829 Virginia Marshall Behavioral Analyst 13901 Amargosa Rd., Victorville, CA 92392 2017-08-15
1346781465 San Bernardino Conty Counselor 15480 Ramona Ave., Victoville, CA 92392 2017-03-09
1841741279 Lorinda Morreale Marriage & Family Therapist 15428 Civic Dr. Ste 200, Act Family Counseling, Victorville, CA 92392 2016-10-20
1235582404 Greater Hope Foundation Community/Behavioral Health 14344 Cajon Avenue, Suite 101, 103, Victorville, CA 92392 2016-07-22
Find all providers in zip 92392

Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568947323 County of San Bernardino Community/Behavioral Health 15345 Bonanza Rd, Victorville, CA 92392-2499 2018-09-27
1558849141 Valley Star Behavioral Health, Inc. Community/Behavioral Health 12188 Hesperia Road, Victorville, CA 92395-5822 2018-08-06
1407365430 Life Skills Awareness Community/Behavioral Health 15353 Bonanza Rd Ste 2, Victorville, CA 92392-2465 2017-09-21
1235582404 Greater Hope Foundation Community/Behavioral Health 14344 Cajon Avenue, Suite 101, 103, Victorville, CA 92392 2016-07-22
1881078517 Harmeling Enterprises LLC Community/Behavioral Health 14443 Park Ave Ste A2, Victorville, CA 92392-2388 2015-07-13
1457626889 Reallifedreams Community/Behavioral Health 14240 Saint Andrews Dr, Suite 101, Victorville, CA 92395-4308 2012-03-19
1215208921 People's Care Autism Services, Inc. Community/Behavioral Health 13901 Amargosa Rd Ste 2, Victorville, CA 92392-2409 2012-01-26
1649498593 San Bernardino County Department of Behavioral Health Community/Behavioral Health 15505 Civic Dr, Victorville, CA 92392-2357 2007-04-23
1104954056 Mental Health Systems, Inc. Community/Behavioral Health 15770 Mojave Dr, Suites K & L, Victorville, CA 92394-1934 2007-03-01
1568813129 Greater Hope Foundation for Children Inc Community/Behavioral Health 14344 Cajon Ave, Suite 101, 102, 103, Victorville, CA 92392-4300 2016-06-24
Find all providers in VICTORVILLE

Competitor

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City VICTORVILLE
Zip Code 92392

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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