VICTORY CLINICAL SERVICES II LLC NPI 1497798284

NPI Information

VICTORY CLINICAL SERVICES II LLC is an addiction medicine family medicine in South Bend, IN. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. VICTORY CLINICAL SERVICES II LLC NPI is 1497798284. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4218 W WESTERN AVE
SOUTH BEND, IN
ZIP 46619-622
Phone: (574) 233-1524
Fax: (574) 233-1612

The provider's authorized official is David Blankenship .
The authorized official title is Administrative Director and has the following contact phone number (574) 233-1524.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 3/22/2012.

Taxonomy Codes

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