{"npi":"1033867569","type":"NPI-2","status":"active","name":{"display":"Victor Community Support Services, Inc.","other":[],"organization_name":"VICTOR COMMUNITY SUPPORT SERVICES, INC.","authorised_official":"Angie Wiechert"},"specialty":{"primary_taxonomy":"251S00000X","primary_taxonomy_description":"Community/Behavioral Health Agency","slug":"community-behavioral-health-agency","schema_org_specialty":null,"all":[{"code":"252Y00000X","description":"Early Intervention Provider Agency","primary":false,"state":null,"license":null},{"code":"261QM0855X","description":"Adolescent and Children Mental Health Clinic/Center","primary":false,"state":null,"license":null},{"code":"251S00000X","description":"Community/Behavioral Health Agency","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"801 EMPIRE ST","city":"FAIRFIELD","state":"CA","postal_code":"945335702","country_code":"US","phone":"7074255744","fax":"7074255162"},{"purpose":"MAILING","street_1":"1360 E LASSEN AVE","city":"CHICO","state":"CA","postal_code":"959737823","country_code":"US","phone":"5308930758","fax":"5308930502"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"01042","state":"CA","issuer":"LEGAL ENTITY NUMBER"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2022-03-14","last_updated":"2024-08-28","_meta":{"source":"NPPES","snapshot_date":"2024-08-28","doc_url":"https://findmynpi.com/api"}}