Provider Demographics
NPI:1912126988
Name:VTC ENTERPRISES
Entity type:Organization
Organization Name:VTC ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:TELANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-928-5000
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93456-1187
Mailing Address - Country:US
Mailing Address - Phone:805-735-3428
Mailing Address - Fax:805-737-4323
Practice Address - Street 1:2445 A ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455
Practice Address - Country:US
Practice Address - Phone:805-928-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC60512FOtherMEDI-CAL PROVIDER #