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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | LEGAL ENTITY # | 01042 | 01 |
Other Name | Type Code |
---|---|
Victor Community Support Services, High Desert | Other Name - Individual/Organization |
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 |
Street Address |
15400 CHOLAME RD |
City | VICTORVILLE |
State | CA |
Zip Code | 92392-2480 |
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 |
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 Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
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] |
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 |
City | VICTORVILLE |
Zip Code | 92392 |
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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.