VICTOR TREATMENT CENTERS, INC (NPI# 1366786782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366786782 |
| Entity Type | Organization |
| Organization Name | VICTOR TREATMENT CENTERS, INC |
| Practice Address |
1053 N D St San Bernardino CA 92410-3521 |
| Practice Telephone | 9514365213 |
| Mailing Telephone | 9514365213 |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |
| Authorized Official Name | JORGE MACIAS (CCT FACILITATOR) |
| Authorized Official Telephone | 9514365200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902082712 | Victor Treatment Centers, Inc | Community Based Residential Treatment Facility, Mental Illness | 555 N Perris Blvd, Perris, CA 92571-2811 | 2008-01-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VICTOR TREATMENT CENTERS, INC. | 1360 E Lassen Ave, Chico, CA 95973-7823 |
| Street Address |
1053 N D ST |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92410-3521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831207489 | Richard George Myatt | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2006-08-25 |
| 1679103543 | Tracy Lynn Wainwright | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2020-01-20 |
| 1174165468 | Elva Alejandra Silva | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-10-08 |
| 1477102796 | Kathryn Christensen | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-09-09 |
| 1780232330 | Victor Samuel Ramirez | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-08-27 |
| 1669029039 | Natalie Salas | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-08-21 |
| 1700431459 | Gerson Yestin Bravo | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-08-08 |
| 1689226672 | Altanyce Brown | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-07-10 |
| 1679133235 | Jessica Jimenez | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-06-17 |
| 1922668854 | Beatrice A De La Cerra | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902303472 | Reina Elora Garcia | Student in an Organized Health Care Education/Training Program | 775 E Base Line St Spc 4, San Bernardino, CA 92410 | 2018-04-10 |
| 1558889881 | Salaunge Lopez | Non-emergency Medical Transport (VAN) | 25942 Baseline St Apt D203, San Bernardino, CA 92410 | 2017-09-07 |
| 1902328578 | Kelly Canady | Counselor | 1100 N. D St., San Bernardino, CA 92410 | 2017-07-14 |
| 1881058592 | Terron Thomas | Contractor | 445 South G, Unit B, San Bernardino, IN 92410 | 2016-04-08 |
| 1982064572 | Zachary Norton-martinez | Specialist/Technologist | 650 Del Rosa Dr, San Bernardino, CA 92410 | 2016-02-25 |
| 1003280934 | Brenda Boyle | Nurse Practitioner | 1455 East 3rd Street, San Bernardino, CA 92410 | 2015-11-16 |
| 1689045197 | Bryan Carter | Physician Assistant | 1455 E 3rd Street, San Bernardino, CA 92410 | 2015-10-09 |
| 1801270137 | Sac Health System | Clinic/Center | 250 South G Street, San Bernardino, CA 92410 | 2015-07-16 |
| 1467852269 | Wilson Dentistry, Inc. | Dentist | 1063 N. D St, San Bernardino, CA 92410 | 2014-08-28 |
| 1629405345 | Terrence John Forrester | Social Worker | 1455 E. 3rd St, San Bernardino, CA 92410 | 2013-09-27 |
| Find all providers in zip 92410 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134693153 | Citadel Community Care Facilities | Residential Treatment Facility, Emotionally Disturbed Children | 568 N Mountain View Ave, San Bernardino, CA 92401-1231 | 2019-01-12 |
| 1295279115 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1255 E Highland Ave Ste 217, San Bernardino, CA 92404-4653 | 2016-12-12 |
| 1457803645 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 731 E 40th St, San Bernardino, CA 92404-1448 | 2016-11-04 |
| 1821540014 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 2965 Garden Dr, San Bernardino, CA 92404-2525 | 2016-11-04 |
| 1770025926 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1004 E Lynwood Dr, San Bernardino, CA 92404-2545 | 2016-11-04 |
| 1770032534 | Lifeskills Development | Residential Treatment Facility, Emotionally Disturbed Children | 6095 Shepherd Dr, San Bernardino, CA 92407-2251 | 2016-09-22 |
| 1811343445 | Starshine Treatment Center, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 460 S Stoddard Ave Ste 1&3, San Bernardino, CA 92401-2001 | 2016-05-12 |
| 1003368655 | Starshine Treatment Center Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1255 E Highland Ave, Ste 215, San Bernardino, CA 92404-6804 | 2016-10-31 |
| 1437499142 | Rey Vargas | Residential Treatment Facility, Emotionally Disturbed Children | 1053 N D St, San Bernardino, CA 92410-3521 | 2013-02-18 |
| 1134467665 | Latoya Jackson | Residential Treatment Facility, Emotionally Disturbed Children | 1053 N D St, San Bernardino, CA 92410-3521 | 2013-01-17 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92410 |
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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.