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VICTORY HEALTH CARE SERVICES LLC NPI 1063910859


NPI Information

NPI: 1063910859
Provider Name: VICTORY HEALTH CARE SERVICES LLC

Doing Business As: VICTORY HEALTH CARE SERVICES LLC

Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
499C BEAUMONT AVENUE
SUITE 18
BALTIMORE, MD
ZIP 21212
Phone: (443) 204-5144
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VICTORY HEALTH CARE SERVICES LLC is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Baltimore, MD. VICTORY HEALTH CARE SERVICES LLC NPI is 1063910859. The provider is registered as an organization entity type.
The provider Is Doing Business As Victory Health Care Services Llc.

The provider's business location address is:

499C BEAUMONT AVENUE
SUITE 18
BALTIMORE, MD
ZIP 21212
Phone: (443) 204-5144
Fax: (667) 212-2430

The provider's authorized official is Bode Akadri .
The authorized official title is Program Director and has the following contact phone number (443) 204-5144.

The enumeration date for this NPI number is 1/26/2018 and was last updated on 7/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0401XClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11972978716MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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