BAKER VICTORY SERVICES NPI 1083867204

NPI Information

BAKER VICTORY SERVICES is a community based residential treatment facility mental illness in Lackawanna, NY. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. BAKER VICTORY SERVICES NPI is 1083867204. The provider is registered as an organization entity type.

The provider's business location address is:

790 RIDGE RD
LACKAWANNA, NY
ZIP 14218-629
Phone: (716) 828-9811

The provider's authorized official is Michael Edbauer .
The authorized official title is Medical Director and has the following contact phone number (716) 828-9357.

The enumeration date for this NPI number is 10/31/2008 and was last updated on 10/31/2008.

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:

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