VICTOR TREATMENT CENTER (NPI# 1518304138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518304138 |
| Entity Type | Organization |
| Organization Name | VICTOR TREATMENT CENTER |
| Practice Address |
3164 Condo Ct Santa Rosa CA 95403-2557 |
| Practice Telephone | 7075767218 |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2013-05-23 |
| Authorized Official Name | JENNI SHIPERLY (MENTAL HEALTH REHAB SPECIALIST) |
| Authorized Official Telephone | 7072918700 |
| 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 |
|---|---|---|---|---|
| 1174965214 | Victor Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 341 Irwin Ln, Santa Rosa, CA 95401-5603 | 2013-07-17 |
| 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 |
3164 CONDO CT |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95403-2557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477665883 | Tom Nixon | Counselor | 3164 Condo Ct, Nvs, Santa Rosa, CA 95403-2557 | 2006-08-31 |
| 1891264321 | Michael White | Psychologist | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2018-11-14 |
| 1396231734 | Samantha Cote | Counselor | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2018-07-09 |
| 1518489004 | Katelyn Marie Brown | Counselor | 3164 Condo Ct, Santa Rosa, CA 95403 | 2017-07-17 |
| 1548628068 | Caitlin C Graham | Counselor | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2016-01-29 |
| 1508207465 | Keith Lamont Adams | Counselor | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2013-07-08 |
| 1669811758 | Erin Brewbaker | Counselor | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2013-06-21 |
| 1194164400 | Ryanesha Warren | Counselor | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2013-06-19 |
| 1962848580 | Victor Treatment Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2013-05-22 |
| 1124363973 | Emily Stice Reeder | Marriage & Family Therapist | 3164 Condo Ct, Santa Rosa, CA 95403-2557 | 2012-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912549841 | Abundance Acupuncture Healing Clinic | Acupuncturist | 3410 Mendocino Avenue, Santa Rosa, CA 95403 | 2019-10-11 |
| 1982161337 | Crystal J Ward | Registered Nurse | 2350 Mendocino Ave, Ste A4, Santa Rosa, CA 95403 | 2019-02-21 |
| 1033674379 | George Edward Griese | Respiratory Therapist, Registered | 501 Bicentennial Way, Santa Rosa, CA 95403 | 2019-01-31 |
| 1508320672 | East-west Natural Medicine Inc. | Acupuncturist | 2200 Range Ave #207, Santa Rosa, CA 95403 | 2019-01-23 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1326519182 | Jkb Solutions Inc. | In Home Supportive Care | 3554 Round Barn Boulevard, Suite 311, Santa Rosa, CA 95403 | 2018-12-05 |
| 1487121265 | Catholic Charities of The Diocese of Santa Rosa | Clinic/Center | 987 Airway Ct, Santa Rosa, CA 95403 | 2018-10-30 |
| 1447746524 | Lisa Jean Quang | Optometrist | 3925 Old Redwood, Medical Office Building 4, Suite 141, Santa Rosa, CA 95403 | 2018-07-02 |
| 1598253353 | Jennifer Renee Lummus | Community Health Worker | 3614 Condo Court, Santa Rosa, CA 95403 | 2018-04-27 |
| 1871042366 | Sadie Thuet | Marriage & Family Therapist | 3434 A Mendocino Ave, Santa Rosa, CA 95403 | 2016-09-26 |
| Find all providers in zip 95403 | ||||
| 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 |
|---|---|---|---|---|
| 1346739273 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 600 Irwin Ln, Santa Rosa, CA 95401-5607 | 2018-05-07 |
| 1891284725 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 620 Irwin Ln, Santa Rosa, CA 95401-5607 | 2018-05-07 |
| 1346739265 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1136 Clover Dr, Santa Rosa, CA 95401-4512 | 2018-05-07 |
| 1417446493 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 520 Oasis Dr, Santa Rosa, CA 95407-7717 | 2018-05-06 |
| 1063901049 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 565 Piezzi Rd, Santa Rosa, CA 95401-5536 | 2018-05-06 |
| 1457841918 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 341 Irwin Ln, Santa Rosa, CA 95401-5603 | 2018-05-10 |
| 1174965214 | Victor Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 341 Irwin Ln, Santa Rosa, CA 95401-5603 | 2013-07-17 |
| 1346459781 | R House, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 183 Pythian Rd, Santa Rosa, CA 95409-6518 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95403 |
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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.