| Victor Community Support Services, Gridley Satellite Office | |
|
650 Kentucky St Ste 1 Gridley CA 95948-2118 | |
| (530) 267-1768 | |
| Not Available |
| Full Name | Victor Community Support Services, Gridley Satellite Office |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 650 Kentucky St Ste 1, Gridley, California |
| Authorized Official Name and Position | Angie R Wiechert (DIRECTOR OF FINANCIAL ANALYSIS) |
| Authorized Official Contact | 5302301210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victor Community Support Services, Gridley Satellite Office 1360 E Lassen Ave Chico CA 95973-7823 Ph: (530) 893-0758 | Victor Community Support Services, Gridley Satellite Office 650 Kentucky St Ste 1 Gridley CA 95948-2118 Ph: (530) 267-1768 |
| NPI Number | 1902534266 |
|---|---|
| Provider Enumeration Date | 08/12/2022 |
| Last Update Date | 08/12/2022 |
| Certification Date | 08/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902534266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | () | Secondary |
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